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BY    PROFESSOR    HOLMES. 


CUEKENTS  AND  COIJNTEE-CUEEENTS  IN  MEDICAL 

SCIENCE. 

With  other  Essays. 

1  vol.    12mo.    Uniform  with  this  volume.     Cloth,  $  1.26. 


TICKNOR  AND  FIELDS,  Publishers. 


BOKDEE  LINES  OFMOWLEME 


IN    SOME   PROVINCES    OF 


MEDICAL    SCIENCE 


AN    INTRODUCTORY    LECTURE, 


Delivered  before  the  Medical  Class  of  Harvard  University, 
November  6th,  1861. 


By  OLIVEE  WENDELL  HOLMES,  M.  D„ 

PARKMAN  PROFESSOR  OP  ANATOMY  AND  PHYSIOLOGY. 


BOSTON: 
TIOKNOR     AND     FIELDS 

18  62. 


.       .      .  '  ■  .  ,   . 

•  ' .  *     


tuOuOGt 
UB3A*& 

2^ 


Entered  according  to  Act  of  Congress,  in  the  year  1862,  by 

OLIVER    WENDELL    HOLMES, 

in  the  Clerk's  Office  of  the  District  Court  of  the  District  of  Massachusetts. 


Cambridge: 

Which,    Bigelow,    and    Company, 

Printers  to  the  University. 


College  Library,  November  22,  1861. 

Professor  0.  W.  Holmes:  — 
Dear  Sir,  —  At  a  meeting  of  the  Medical  Class  it  was  unanimously 
voted,  that  your  Introductory  Address  be  published.    We  therefore  take 
much  pleasure  in  requesting  of  you  a  copy  for  that  purpose. 


Truly  your  friends, 


WM.  J.  RADFORD,  Chairman. 
W.  K.  FLETCHER, 
W.  H.  MACDONALD,  \ 
D.  H.  HAYDEN, 


'} 


Boston,  November  25,  1861. 

Gentlemen:  — 
It  pleases  me  to  comply  with  the  request  you  have  addressed  me,  in 
accordance  with  the  vote  of  the  Medical  Class,  to  furnish  you  a  copy 
of  my  Introductory  Lecture  for  publication. 

Very  truly  your  friend, 

0.  W.  HOLMES. 
Messrs.  Wm.  J.  Radford,  Chairman. 

W.  K.  Fletcher,     ~\ 

W.  H.  Macdonald,  >•  Committee. 

D.  H.  Hayden,        ) 


615817 


TO   THE   READER 


This  Lecture  appears  as  it  would  have  been  delivered 
had  the  time  allowed  been  less  strictly  limited.  Passages 
necessarily  omitted  have  been  restored,  and  points  briefly 
touched  have  been  more  fully  considered.  A  few  notes 
have  been  added  for  the  benefit  of  that  limited  class  of 
students  who  care  to  track  an  author  through  the  high- 
ways and  by-ways  of  his  reading.  I  owe  my  thanks  to 
several  of  my  professional  brethren  who  have  communi- 
cated with  me  on  subjects  with  which  they  are  familiar ; 
especially  to  Dr.  John  Dean,  for  the  opportunity  of  profit- 
ing by  his  unpublished  labors,  and  to  Dr.  Hasket  Derby, 
for  information  and  references  to  recent  authorities  relating 
to  the  anatomy  and  physiology  of  the  eye. 


LECTURE. 


The  entrance  upon  a  new  course  of  Lectures  is 
always  a  period  of  interest  to  instructors  and  pupils. 
As  the  birth  of  a  child  to  a  parent,  so  is  the  advent  of 
a  new  class  to  a  teacher.  As  the  light  of  the  untried 
world  to  the  infant,  so  is  the  dawning  of  the  light  rest- 
ing over  the  unexplored  realms  of  science  to  the  stu- 
dent. In  the  name  of  the  Faculty  I  welcome  you, 
Gentlemen  of  the  Medical  Class,  new-born  babes  of 
science,  or  lustier  nurslings,  to  this  morning  of  your 
medical  life,  and  to  the  arms  and  the  bosom  of  this 
ancient  University.  Fourteen  years  ago  I  stood  in 
this  place  for  the  first  time  to  address  those  who  occu- 
pied these  benches.  As  I  recall  these  past  seasons  of 
our  joint  labors,  I  feel  that  they  have  been  on  the 
whole  prosperous,  and  not  undeserving  of  their  pros- 
perity. For  it  has  been  my  privilege  to  be  associated 
with  a  body  of  true  and  faithful  workers ;  I  cannot 
praise  them  freely  to  their  faces,  or  I  should  be  proud 
to  discourse  of  the  harmonious  diligence  and  the  noble 
spirit  in  which  they  have  toiled  together,  not  merely 


6  BORDER  LINES   OF  KNOWLEDGE 

to  teach  their  several  branches,  but  to  elevate  the 
whole  standard  of  teaching. 

I  may  speak  with  less  restraint  of  those  gentlemen 
who  have  aided  me  in  the  most  laborious  part  of  my 
daily  duties,  the  Demonstrators,  to  whom  the  succes- 
sive classes  have  owed  so  much  of  their  instruction. 
They  rise  before  me,  the  dead  and  the  living,  in  the 
midst  of  the  most  grateful  recollections.  The  fair, 
manly  face  and  stately  figure  of  my  friend,  Dr.  Sam- 
uel Parkman,  himself  fit  for  the  highest  offices  of 
teaching,  yet  willing  to  be  my  faithful  assistant  in  the 
time  of  need,  come  back  to  me  with  the  long  sigh  of 
regret  for  his  early  loss  to  our  earthly  companionship. 
Every  year  I  speak  the  eulogy  of  Dr.  Ainsworth's  pa- 
tient toil  as  I  show  his  elaborate  preparations.  When 
I  take  down  my  American  Cyclopaedia  and  borrow  in- 
struction from  the  learned  articles  of  Dr.  Kneeland, 
I  cease  to  regret  that  his  indefatigable  and  intelligent 
industry  was  turned  into  a  broader  channel.  And 
what  can  I  say  too  cordial  of  my  long  associated  com- 
panion and  friend,  Dr.  Hodges,  whose  admirable  skill, 
working  through  the  swiftest  and  surest  fingers  that 
ever  held  a  scalpel  among  us,  has  delighted  class  after 
class,  and  filled  our  Museum  with  monuments  which 
will  convey  his  name  to  unborn  generations  ? 

This  day  belongs,  however,  not  to  myself  and  my 
recollections,  but  to  all  of  us  who  teach  and  all  of  you 
who  listen,  whether  experts  in  our  specialties  or  aliens 
to  their  mysteries,  or  timid  neophytes  just  entering  the 


IN  MEDICAL   SCIENCE.  7 

portals  of  the  hall  of  science.  Look  in  with  me,  then, 
while  I  attempt  to  throw  some  rays  into  its  interior, 
which  shall  illuminate  a  few  of  its  pillars  and  cornices, 
and  show  at  the  same  time  how  many  niches  and  al- 
coves remain  in  darkness. 

Science  is  the  topography  of  ignorance.  From  a  few 
elevated  points  we  triangulate  vast  spaces,  enclosing  in- 
finite unknown  details.  We  cast  the  lead,  and  draw  up 
a  little  sand  from  abysses  we  shall  never  reach  with 
our  dredges. 

The  best  part  of  our  knowledge  is  that  which  teaches 
us  where  knowledge  leaves  off  and  ignorance  begins. 
Nothing  more  clearly  separates  a  vulgar  from  a  supe- 
rior mind,  than  the  confusion  in  the  first  between  the 
little  that  it  truly  knows,  on  the  one  hand,  and  what  it 
half  knows  and  what  it  thinks  it  knows,  on  the  other. 

That  which  is  true  of  every  subject  is  especially  true 
of  the  branch  of  knowledge  which  deals  with  living 
beings.  Their  existence  is  a  perpetual  death  and  re- 
animation.  Their  identity  is  only  an  idea,  for  we  put 
off  our  bodies  many  times  during  our  lives,  and  dress 
in  new  suits  of  bones  and  muscles.* 

"  Thou  art  not  thyself; 
.    For  thou  exist'  st  on  many  a  thousand  grains 
N  That  issue  out  of  dust." 


*  "  Occasio  enim  praeceps  est  propter  artis  materiam,  dico  autem  cor- 
pus, quod  continue  Suit  et  momento  temporis  transmutatur."  —  Galen. 
Com.  in  Aphorism.  Hippoc.  1. 1. 


8  BORDER  LINES   OF  KNOWLEDGE 

If  it  is  true  that  we  understand  ourselves  but  imper- 
fectly in  health,  it  is  more  signally  manifest  in  disease, 
where  natural  actions  imperfectly  understood,  disturbed 
in  an  obscure  way  by  half-seen  causes,  are  creeping  and 
winding  along  in  the  dark  toward  their  destined  issue, 
sometimes  using  our  remedies  as  safe  stepping-stones, 
occasionally,  it  may  be,  stumbling  over  them  as  ob- 
stacles. 

I  propose  in  this  lecture  to  show  you  some  points  of 
contact  between  our  ignorance  and  our  knowledge  in 
several  of  the  branches  upon  the  study  of  which  you 
are  entering.  I  may  teach  you  a  very  little  directly, 
but  I  hope  much  more  from  the  trains  of  thought  I 
shall  suggest.  Do  not  expect  too  much  ground  to  be 
covered  in  this  rapid  survey.  Our  task  is  only  that  of 
sending  out  a  few  pickets  under  the  starry  flag  of  sci- 
ence to  the  edge  of  that  dark  domain  where  the  ensigns 
of  the  obstinate  rebel,  Ignorance,  are  flying  undisputed. 
We  are  not  making  a  reconnoissance  in  force,  still  less 
advancing  with  the  main  column.  But  here  are  a  few 
roads  along  which  we  have  to  march  together,  and  we 
wish  to  see  clearly  how  far  our  lines  extend,  and  where 
the  enemy's  outposts  begin. 

Before  touching  the  branches  of  knowledge  that  deal 
with  organization  and  vital  functions,  let  us  glance  at 
that  science  which  meets  you  at  the  threshold  of  your 
study,  and  prepares  you  in  some  measure  to  deal  with 
the  more  complex  problems  of  the  living  laboratory. 


IN  MEDICAL   SCIENCE.  9 

Chemistry  includes  the  art  of  separating  and  com- 
bining the  elements  of  matter,  and  the  study  of  the 
changes  produced  by  these  operations.  We  can  hardly 
say  too  much  of  what  it  has  contributed  to  our  knowl- 
edge of  the  universe  and  our  power  of  dealing  with  its 
materials.  It  has  given  us  a  catalogue  raisonnS  of  the 
substances  found  upon  our  planet,  and  shown  how 
everything  living  and  dead  is  put  together  from  them. 
It  is  accomplishing  wonders  before  us  every  day,  such 
as  Arabian  story-tellers  used  to  string  together  in  their 
fables.  It  spreads  the  sensitive  film  on  the  artificial 
retina  which  looks  upon  us  through  the  optician's  lens 
for  a  few  seconds,  and  fixes  an  image  that  will  outlive 
its  original.  It  questions  the  light  of  the  sun,  and  de- 
tects the  vaporized  metals  floating  around  the  great 
luminary,  —  iron,  sodium,  lithium,  and  the  rest,  —  as 
if  the  chemist  of  our  remote  planet  could  fill  his  bell- 
glasses  from  its  fiery  atmosphere.*  It  lends  the  power 
which  flashes  our  messages  in  thrills  that  leave  the  lazy 
chariot  of  day  behind  them.  It  seals  up  a  few  dark 
grains  in  iron  vases,  and  lo !  at  the  touch  of  a  single 
spark,  rises  in  smoke  and  flame  a  mighty  Afrit  with  a 
voice  like  thunder  and  an  arm  that  shatters  like  an 
earthquake.  The  dreams  of  Oriental  fancy  have  be- 
come the  sober  facts  of  our  every-day  life,  and  the 
chemist  is  the  magician  to  whom  we  owe  them. 

To  return  to  the  colder  scientific  aspect  of  chemis- 

*  Scientific  Annual  for  1861.  —  Fairbairn's  Address  before  the  British 
Association,  1861. 


10  BORDER  LINES   OF  KNOWLEDGE 

try.  It  has  shown  us  how  bodies  stand  affected  to 
each  other  through  an  almost  boundless  range  of  com- 
binations.  It  has  given  us  a  most  ingenious  theory  to 
account  for  certain  fixed  relations  in  these  combina- 
tions. It  has  successfully  eliminated  a  great  number 
of  proximate  compounds,  more  or  less  stable,  from  or- 
ganic structures.  It  has  invented  others  which  form 
the  basis  of  long  series  of  well-known  composite  sub- 
stances. In  fact,  we  are  perhaps  becoming  overbur- 
dened with  our  list  of  proximate  principles,  demon- 
strated and  hypothetical. 

How  much  nearer  have  we  come  to  the  secret  of 
force  than  Lully  and  Geber  and  the  whole  crew  of 
juggling  alchemists  ?  We  have  learned  a  great  deal 
about  the  how,  what  have  we  learned  about  the  why  ? 

Why  does  iron  rust,  while  gold  remains  untarnished, 
and  gold  amalgamate,  while  iron  refuses  the  alliance  of 
mercury  ? 

The  alchemists  called  gold  Sol,  the  sun,  and  iron 
Mars,  and  pleased  themselves  with  fancied  relations 
between  these  substances  and  the  heavenly  bodies,  by 
which  they  pretended  to  explain  the  facts  they  ob- 
served. Some  of  their  superstitions  have  lingered  in 
practical  medicine  to  the  present  day,  but  chemistry 
has  grown  wise  enough  to  confess  the  fact  of  absolute 
ignorance. 

What  is  it  that  makes  common  salt  crystallize  in  the 
form  of  cubes,  and  saltpetre  in  the  shape  of  six-sided 
prisms  ?     We  see  no  reason  why  it  should  not  have 


W  MEDICAL   SCIENCE.  11 

been  just  the  other  way,  salt  in  prisms  and  saltpetre 
in  cubes,  or  why  either  should  take  an  exact  geometri- 
cal outline,  any  more  than  coagulating  albumen. 

But  although  we  had  given  up  attempting  to  explain 
the  essential  nature  of  affinities  and  of  crystalline  types, 
we  might  have  supposed  that  we  had  at  least  fixed  the 
identity  of  the  substances  with  which  we  deal,  and  de- 
termined the  laws  of  their  combination.  All  at  once 
we  find  that  a  simple  substance  changes  face,  puts  off  its 
characteristic  qualities  and  resumes  them  at  will;  —  not 
merely  when  we  liquefy  or  vaporize  a  solid,  or  reverse 
the  process  ;  but  that  a  solid  is  literally  transformed 
into  another  solid  under  our  own  eyes.  We  thought 
we  knew  phosphorus.  We  warm  a  portion  of  it  sealed 
in  an  empty  tube,  for  about  a  week.  It  has  become  a 
brown  infusible  substance,  which  does  not  shine  in  the 
dark  nor  oxidate  in  the  air.  We  heat  it  to  500°  F., 
and  it  becomes  common  phosphorus  again.  We  trans- 
mute sulphur  in  the  same  singular  way.  Nature,  you 
know,  gives  us  carbon  in  the  shape  of  coal  and  in  that 
of  the  diamond.  It  is  easy  to  call  these  changes  by  the 
name  allotrojoism,  but  not  the  less  do  they  confound  our 
hasty  generalizations. 

These  facts  of  allotropism  have  some  corollaries  con- 
nected with  them  rather  startling  to  us  of  the  nine- 
teenth century.  There  may  be  other  transmutations 
possible  besides  those  of  phosphorus  and  sulphur, 
When  Dr.  Prout,  in  1840,  talked  about  azote  and  car- 
bon being   "formed"   in   the   living   system,   it   was 


12  BOEDER  LINES   OF   KNOWLEDGE 

looked  upon  as  one  of  those  freaks  of  fancy  to  which 
philosophers,  like  other  men,  are  subject.  But  when 
Professor  Faraday,  in  1851,  says,  at  a  meeting  of  the 
British  Association,  that  "  his  hopes  are  in  the  direc- 
tion of  proving  that  bodies  called  simple  were  really 
compounds,  and  may  be  formed  artificially  as  soon  as 
we  are  masters  of  the  laws  influencing  their  combina- 
tions,"—  when  he  comes  forward  and  says  that  he  has 
tried  experiments  at  transmutation,  and  means,  if  his 
life  is  spared,  to  try  them  again,  —  how  can  we  be  sur- 
prised at  the  popular  story  of  1861,  that  Louis  Napo- 
leon has  established  a  gold-factory  and  is  glutting  the 
mints  of  Europe  with  bullion  of  his  own  making  ? 

And  so  with  reference  to  the  law  of  combinations. 
The  old  maxim  was,  Corpora  non  agunt  nisi  soluta.  If 
two  substances,  a  and  b,  are  enclosed  in  a  glass  vessel,  c, 
we  do  not  expect  the  glass  to  change  them,  unless  a 
or  b  or  the  compound  a  b  has  the  power  of  dissolving 
the  glass.  But  if  for  a  I  take  oxygen,  for  b  hydrogen, 
and  for  c  &  piece  of  spongy  platinum,  I  find  the  first 
two  combine  with  the  common  signs  of  combustion 
and  form  water,  the  third  in  the  mean  time  under- 
going no  perceptible  change.  It  has  played  the  part 
of  the  unwedded  priest,  who  marries  a  pair  without 
taking  a  fee  or  having  any  further  relation  with  the 
parties.  We  call  this  catalysis,  catalytic  action,  the  ac- 
tion of  presence,  or  by  what  learned  name  we  choose. 
Give  what  name  to  it  we  will,  it  is  a  manifestation  of 
power  which  crosses  our  established  laws  of  combina- 


IN  MEDICAL   SCIENCE.  13 

tion  at  a  very  open  angle  of  intersection.  I  think  we 
may  find  an  analogy  for  it  in  electrical  induction,  the 
disturbance  of  the  equilibrium  of  the  electricity  of  a 
body  by  the  approach  of  a  charged  body  to  it,  without 
interchange  of  electrical  conditions  between  the  two 
bodies.  But  an  analogy  is  not  an  explanation,  and 
why  a  few  drops  of  yeast  should  change  a  saccharine 

'  mixture  to  carbonic  acid  and  alcohol,  —  a  little  leaven 
leavening  the  whole  lump,  —  not  by  combining  with  it, 
but  by  setting  a  movement  at  work,  we  not  only  can- 
not explain,  but  the  fact  is  such  an  exception  to  the 
recognized  laws  of  combination,  that  Liebig  is  unwilling 
to  admit  the  new  force  at  all  to  which  Berzelius  had 
given  the  name  so  generally  accepted. 

The  phenomena  of  isomerism,  or  identity  of  compo- 
sition and  proportions  of  constituents  with  difference 

/  of  qualities,  and  of  isomorphism,  or  identity  of  form  in 
crystals  which  have  one  element  substituted  for  another, 
were  equally  surprises  to  science ;  and  although  the 
mechanism  by  which  they  are  brought  about  can  be 
to  a  certain  extent  explained  by  a  reference  to  the 
hypothetical  atoms  of  which  the  elements  are  consti- 
tuted, yet  this  is  only  turning  the  difficulty  into  a  frac- 
tion with  an  infinitesimal  denominator  and  an  infinite 
numerator. 

So  far  we  have  studied  the  working  of  force  and 
its  seeming  anomalies  in  purely  chemical  phenomena. 
But  we  soon  find  that  chemical  force  is  developed  by 
various  other  physical  agencies,  —  by  heat,  by  light,  by 


14  BORDER  LINES   OF  KNOWLEDGE 

electricity,  by  magnetism,  by  mechanical  agencies  ; 
and,  vice  versa,  that  chemical  action  develops  heat, 
light,  electricity,  magnetism,  mechanical  force,  as  we 
see  in  our  matches,  galvanic  batteries,  and  explosive 
compounds.  Proceeding  with  our  experiments,  we 
find  that  every  kind  of  force  is  capable  of  producing 
all  other  kinds,  or,  in  Mr.  Faraday's  language,  that 
"  the.  various  forms  under  which  the  forces  of  matter 
are  made  manifest  have  a  common  origin,  or,  in  other 
words,  are  so  directly  related  and  mutually  dependent 
that  they  are  convertible  one  into  another." 

Out  of  this  doctrine  naturally  springs  that  of  the 
conservation  of  force,  so  ably  illustrated  by  Mr.  Grove, 
Dr.  Carpenter,  and  Mr.  Faraday.  This  idea  is  no 
novelty,  though  it  seems  so  at  first  sight.  It  was 
maintained  and  disputed  among  the  giants  of  philos- 
ophy. Des  Cartes  and  Leibnitz  denied  that  any  new 
motion  originated  in  nature,  or  that  any  ever  ceased 
to  exist ;  all  motion  being  in  a  circle,  passing  from 
one  body  to  another,  one  losing  what  the  other  gained. 
Newton,  on  the  other  hand,  believed  that  new  motions 
were  generated  and  existing  ones  destroyed.  On  the 
first  supposition,  there  is  a  fixed  amount  of  force  al- 
ways circulating  in  the  universe.  On  the  second,  the 
total  amount  may  bev  increasing  or  diminishing.  You 
will  find  in  the  Annual  of  Scientific  Discovery  for 
1858  a  very  interesting  lecture  by  Professor  Helm- 
holtz  of  Bonn,  in  which  it  is  maintained  that  a  cer- 
tain portion  of  force  is  lost  in  every  natural  process, 


IN  MEDICAL   SCIENCE.  15 

being  converted  into  unchangeable  heat,  so  that  the 
universe  will  come  to  a  stand-still  at  last,  all  force  pass- 
ing into  heat,  and  all  heat  into  a  state  of  equilibrium. 

The  doctrines  of  the  convertibility  or  specific  equiv- 
alence of  the  various  forms  of  force,  and  of  its  conser- 
vation, which  is  its  logical  consequence,  are  very  gen- 
erally accepted,  as  I  believe,  at  the  present  time, 
among  physicists.  We  are  naturally  led  to  the  ques- 
tion, What  is  the  nature  of  force  ?  The  three  illus- 
trious philosophers  just  referred  to  agree  in  attributing 
the  general  movements  of  the  universe  to  the  imme- 
diate Divine  action.*  The  doctrine  of  "  pre-established 
harmony''  was  an  especial  contrivance  of  Leibnitz  to 
remove  the  Creator  from  unworthy  association  with 
the  less  divine  acts  of  living  beings.  Obsolete  as  this 
expression  sounds  to  our  ears,  the  phrase  laws  of  the 
universe,  which  we  use  so  contantly  with  a  wider  ap- 
plication, appears  to  me  essentially  identical  with  it. 

Force  does  not  admit  of  explanation,  nor  of  proper 


*  "  Et  generalem  quod  attinet,  manifestum  mihi  videtur  illam  [causam] 
non  aliam  esse,  quam  Deum  ipsum,  qui  materiam  simul  cum  motu  et 
quiete  in  principio  creavit,  jamque  per  solum  suum  concursum  ordinarium, 
tantundem  motus  et  quietis  in  ea  tota  quantum  tunc  posuit  conservat: .... 
eodem  plane  modo,  eademque  ratione  qua  prius  creavit,  eum  etiam  tantun- 
dem motus  in  ipsa  semper  conservare."  —  Des  Cartes,  Princ.  Phil.,  P.  II. 
§  XXXVI. 

"  Concursus  Dei,  actioni  creaturse  necessarius."  —  Leibnitz,  Op.,  Tom. 
VI.  p.  174. 

"  In  ipso  continentur  et  moventur  universa,  sed  absque  mutua  passione. 
Deus  nihil  patitur  ex  corporum  motibus :  ilia  nullam  sentiunt  resistentiam 
ex  omniprgesentia  Dei."  —  Newton,  Principia,  Lib.  III.  Schol.  Gen. 


/ 


16  BORDER  LINES   OF  KNOWLEDGE 

definition,  any  more  than  the  hypothetical  substratum 
of  matter.  If  we  assume  the  Infinite  as  omnipresent, 
omniscient,  omnipotent,  we  cannot  suppose  Him  ex- 
cluded from  any  part  of  His  creation,  except  from 
rebellious  souls  which  voluntarily  exclude  Him  by 
the  exercise  of  their  fatal  prerogative  of  free-will.* 
Force,  then,  is  the  act  of  immanent  Divinity.  I  find 
no  meaning  in  mechanical  explanations.  Newton's  hy- 
pothesis of  an  ether  filling  the  heavenly  spaces  does 
not,  I  confess,  help  my  conceptions.  I  will,  and  the 
muscles  of  my  vocal  organs  shape  my  speech.  God 
wills,  and  the  universe  articulates  His  power,  wisdom, 
and  goodness.  That  is  all  I  know.  There  is  no  bridge 
my  mind  can  throw  from  the  "immaterial"  cause  to 
the  "material"  effect. 

The  problem  of  force  meets  us  everywhere,  and  I 
prefer  to  encounter  it  in  the  world  of  physical  phenom- 
ena before  reaching  that  of  living  actions.  It  is#only 
the  name  for  the  incomprehensible  cause  of  certain 
changes  known  to  our  consciousness,  and  assumed  to  be 
outside  of  it.     For  me  it  is  the  Deity  Himself  in  action. 

I  can  therefore  see  a  large  significance  in  the  some- 

*  M  Cum  unaquaeque  spatii  particula  sit  semper,  et  unumquodque  duratio- 
nis  indivisibile  momentum  ubique;  certe  rerum  omnium  Fabricator  ac 
Dominus  non  erit  nunquam  nusquam.  Omniprsesens  est  non  per  virtutem 
solam,  sed  etiam  per  substantiam ;  nam  virtus  sine  substantia  subsistere 
non  potest."  —  Newton,  loc.  cit. 

"  The  Lord  of  all,  himself  through  all  diffused, 
Sustains  and  is  the  life  of  all  that  lives." 

The  Task,  B.  VI.  1.  221,  222. 


/ 


IN  MEDICAL  SCIENCE.  17 

what  bold  language  of  Burdach :  "  There  is  for  me 
but  one  miracle,  that  of  infinite  existence,  and  but  one 
mystery,  the  manner  in  which  the  finite  proceeds  from 
the  infinite.  So  soon  as  we  recognize  this  incompre- 
hensible act  as  the  general  and  primordial  miracle,  of 
which  our  reason  perceives  the  necessity,  but  the  man- 
ner of  which  our  intelligence  cannot  grasp,  so  soon  as 
we  contemplate  the  nature  known  to  us  by  experience, 
in  this  light,  there  is  for  us  no  other  impenetrable  mir- 
acle or  mystery."  * 

Let  us  turn  to  a  branch  of  knowledge  which  deals 
with  certainties  up  to  the  limit  of  the  senses,  and  is 
involved  in  no  speculations  beyond  them.  In  certain 
points  of  view,  Human  Anatomy  may  be  considered 
an  almost  exhausted  science.  From  time  to  time  some 
small  organ  which  had  escaped  earlier  observers  has 
been  pointed  out,  —  such  parts  as  the  tensor  tarsi,  the 
otic  ganglion,  or  the  Pacinian  bodies;  but  some  of 
our  best  anatomical  works  are  those  which  have  been 
classic  for  many  generations.  The  plates  of  the  bones 
in  Vesalius,  three  centuries  old,  are  still  masterpieces 
of  accuracy,  as  of  art.  The  magnificent  work  of  Albi- 
nus  on  the  muscles,  published  in  1747,  is  still  supreme 
in  its  department,  as  the  constant  references  of  the 
most  thorough  recent  treatise  on  the  subject,  that  of 
Theile,  sufficiently  show.  More  has  been  done  in 
unravelling  the  mysteries  of  the  fasciae,  but  there  has 

*  Physiologie,  Trad,  de  Jourdan,  II.  326. 


18  BORDER  LINES   OF  KNOWLEDGE 

been  a  tendency  to  overdo  this  kind  of  material  analy- 
sis. Alexander  Thomson  split  them  up  into  cobwebs, 
as  you  may  see  in  the  plates  to  Velpeau's  Surgical 
Anatomy.  I  well  remember  how  he  used  to  shake 
his  head  over  the  coarse  work  of  Scarpa  and  Astley 
Cooper,  —  as  if  Denner,  who  painted  the  separate  hairs 
of  the  beard  and  pores  of  the  skin  in  his  portraits,  had 
spoken  lightly  of  the  pictures  of  Rubens  and  Vandyk. 

Not  only  has  little  been  added  to  the  catalogue  of 
parts,  but  some  things  long  known  had  become  half- 
forgotten.  Louis  and  others  confounded  the  solitary 
glands  of  the  lower  part  of  the  small  intestine  with 
those  which  "  the  great  Brunner,"  as  Haller  calls  him, 
described  in  1687  as  being  found  in  the  duodenum. 
The  display  of  the  fibrous  structure  of  the  brain  seemed 
a  novelty  as  shown  by  Spurzheim.  One  is  startled  to 
find  the  method  anticipated  by  Raymond  Vieussens 
nearly  two  centuries  ago.  I  can  hardly  think  Gordon 
had  ever  looked  at  his  figures,  though  he  names  their 
author,  when  he  wrote  the  captious  and  sneering  arti- 
cle which  attracted  so  much  attention  in  the  pages  of 
the  Edinburgh  Review.* 

This  is  the  place,  if  anywhere,  to  mention  any  ob- 
servations I  could  pretend  to  have  made  in  the  course 
of  my  teaching  the  structure  of  the  human  body.  I 
can  make  no  better  show  than  most  of  my  predecessors 
in  this  well-reaped  field.  The  nucleated  cells  found 
connected  with  the  cancellated  structure  of  the  bones, 

*  June,  1815. 


W  MEDICAL   SCIENCE.  19 

which  I  first  pointed  out  and  had  figured  in  1847,  and 
have  shown  yearly  from  that  time  to  the  present,  and 
the  fossa  rnasseterica,  a  shallow  concavity  on  the  ramus 
of  the  lower  jaw,  for  the  lodgement  of  the  masseter 
muscle,  which  acquires  significance  when  examined  by 
the  side  of  the  deep  cavity  on  the  corresponding  part 
in  some  carnivora  to  which  it  answers,  may  perhaps  be 
claimed  as  deserving  attention.  I  have  also  pleased 
myself  by  making  a  special  group  of  the  six  radiating 
muscles  *  which  diverge  from  the  spine  of  the  axis,  or 
second  cervical  vertebra,  and  by  giving  to  it  the  name 
Stella  musculosa  nuchce.  But  this  scanty  catalogue  is 
only  an  evidence  that  one  may  teach  long  and  see  little 
that  has  not  been  noted  by  those  who  have  gone  before 
him.  Of  course  I  do  not  think  it  necessary  to  include 
rare,  but  already  described  anomalies,  such  as  the  epi- 
sternal  bones,  the  rectus  sternalis,  and  other  interesting 
exceptional  formations  I  have  encountered,  which  have 
shown  a  curious  tendency  to  present  themselves  sev- 
eral times  in  the  same  season,  perhaps  because  the 
first  specimen  found  calls  our  attention  to  any  we  may 
subsequently  meet  with. 

The  anatomy  of  the  scalpel  and  the  amphitheatre 
was,  then,  becoming  an  exhausted  branch  of  investiga- 
tion. But  during  the  present  century  the  study  of  the 
human  body  has  changed  its  old  aspect,  and  become 
fertile  in  new  observations.     This  rejuvenescence  was 

*  Rectus  capitis  posticus  major,  obliquus  capitis  inferior,  and  semispinalis 
colli,  on  each  side. 


20  BORDER  LINES   OF  KNOWLEDGE 

effected  by  means  of  two  principal  agencies,  —  new 
methods  and  a  new  instrument. 

Descriptive  anatomy,  as  known  from  an  early  date, 
is  to  the  body  what  geography  is  to  the  planet.  Now 
geography  was  pretty  well  known  so  long  ago  as  when 
Arrowsmith,  who  was  born  in  1750,  published  his  ad- 
mirable maps.  But  in  that  same  year  was  born  Wer- 
ner, who  taught  a  new  way  of  studying  the  earth, 
since  become  familiar  to  us  all  under  the  name  of 
Geology. 

What  geology  has  done  for  our  knowledge  of  the 
earth,  has  been  done  for  our  knowledge  of  the  body  by 
that  method  of  study  to  which  is  given  the  name  of 
General  Anatomy.  It  studies,  not  the  organs  as  such, 
but  the  elements  out  of  which  the  organs  are  con- 
structed. It  is  the  geology  of  the  body,  as  that  is  the 
general  anatomy  of  the  earth.  The  extraordinary 
genius  of  Bichat,  to  whom  more  than  any  other  we 
owe  this  new  method  of  study,  does  not  require  Mr. 
Buckle's  testimony  to  impress  the  practitioner  with 
the  importance  of  its  achievements.  I  have  heard  a 
very  wise  physician  question  whether  any  important 
result  had  accrued  to  practical  medicine  from  Harvey's 
discovery  of  the  circulation.  But  Anatomy,  Physiol- 
ogy, and  Pathology  have  received  a  new  light  from 
this  novel  method  of  contemplating  the  living  struc- 
tures, which  has  had  a  vast  influence  in  enabling  the 
practitioner  at  least  to  distinguish  and  predict  the 
course  of  disease.     We  know  as  well  what  differences 


IN  MEDICAL   SCIENCE.  21 

to  expect  in  the  habits  of  a  mucous  and  of  a  serous 
membrane,  as  what  mineral  substances  to  look  for  in 
the  chalk  or  the  coal  measures.  You  have  only  to 
read  Cullen's  description  of  inflammation  of  the  lungs 
or  of  the  bowels,  and  compare  it  with  such  as  you  may 
find  in  Laennec  or  Watson,  to  see  the  immense  gain 
which  diagnosis  and  prognosis  have  derived  from  gen- 
eral anatomy. 

The  second  new  method  of  studying  the  human 
structure,  beginning  with  the  labors  of  Scarpa,  Burns, 
and  Colles,  grew  up  principally  during  the  first  third 
of  this  century.  It  does  not  deal  with  organs,  as 
did  the  earlier  anatomists,  nor  with  tissues,  after  the 
manner  of  Bichat.  It  maps  the  whole  surface  of  the 
body  into  an  arbitrary  number  of  regions,  and  studies 
each  region  successively  from  the  surface  to  the  bone, 
or  beneath  it.  This  hardly  deserves  the  name  of  a  sci- 
ence, although  Velpeau  has  dignified  it  with  that  title, 
but  it  furnishes  an  admirable  practical  way  for  the  sur- 
geon who  has  to  operate  on  a  particular  region  of  the 
body  to  study  that  region.  If  we  are  buying  a  farm, 
we  are  not  content  with  the  State  map  or  a  geological 
chart  including  the  estate  in  question.  We  demand 
an  exact  survey  of  that  particular  property,  so  that  we 
may  know  what  we  are  dealing  with.  This  is  just 
what  regional,  or,  as  it  is  sometimes  called,  surgical 
anatomy,  does  for  the  surgeon  with  reference  to  the 
part  on  which  his  skill  is  to  be  exercised.  It  enables 
him  to  see  with  the  mind's  eye  through  the  opaque  tis- 


22  BORDER  LINES   OF  KNOWLEDGE 

sues  down  to  the  bone  on  which  they  he,  as  if  the  skin 
were  transparent  as  the  cornea,  and  the  organs  it  cov- 
ers translucent  as  the  gelatinous  pulp  of  a  medusa. 

It  is  curious  that  the  Japanese  should  have  antici- 
pated Europe  in  a  kind  of  rude  regional  anatomy.  I 
have  seen  a  manikin  of  Japanese  make  traced  all  over 
with  lines,  and  points  marking  their  intersection.  By 
this  their  doctors  are  guided  in  the  performance  of  acu- 
puncture, marking  the  safe  places  to  thrust  in  needles, 
as  we  buoy  out  our  ship-channels,  and  doubtless  indi- 
cating to  learned  eyes  the  spots  where  incautious  med- 
dling had  led  to  those  little  accidents  of  shipwreck  to 
which  patients  are  unfortunately  liable. 

A  change  of  method,  then,  has  given  us  General 
and  Regional  Anatomy.  These,  too,  have  been 
worked  so  thoroughly,  that,  if  not  exhausted,  they 
have  at  least  become  to  a  great  extent  fixed  and  pos- 
itive branches  of  knowledge.  But  the  first  of  them, 
General  Anatomy,  would  never  have  reached  this 
positive  condition  but  for  the  introduction  of  that  in- 
strument which  I  have  mentioned  as  the  second  great 
aid  to  modern  progress. 

This  instrument  is  the  achromatic  microscope.  For 
the  history  of  the  successive  steps  by  which  it  became 
the  effective  scientific  implement  we  now  possess,  I 
must  refer  you  to  the  work  of  Mr.  Quekett,  to  an 
excellent  article  in  the  Penny  Cyclopaedia,  or  to  that 
of  Sir  David  Brewster  in  the  Encyclopaedia  Britannica. 
It  is  a  most  interesting  piece  of  scientific  history,  which 


IN  MEDICAL   SCIENCE.  23 

shows  how  the  problem  that  Biot  in  1821  pronounced 
insolvable  was  in  the  course  of  a  few  years  practically 
solved,  with  a  success  equal  to  that  which  Dollond  had 
long  before  obtained  with  the  telescope.  It  is  enough 
for  our  purpose  that  we  are  now  in  possession  of  an 
instrument    freed    from   all   confusions   and    illusions, 

/  which  magnifies  a  thousand  diameters,  —  a  million 
times  in  surface,  —  without  serious  distortion  or  dis- 
coloration of  its  object. 

A  quarter  of  a  century  ago,  or  a  little  more,  an 
instructor  would  not  have  hesitated  to  put  John  Bell's 
Anatomy  and  Bostock's  Physiology  into  a  student's 
hands,  as  good  authority  on  their  respective  subjects. 
Let  us  not  be  unjust  to  either  of  these  authors.     John 

I  Bell  is  the  liveliest  medical  writer  that  I  can  remember 
who  has  written  since  the  days  of  delightful  old  Am- 
broise  Pare*.  His  picturesque  descriptions  and  bold 
figures  are  as  good  now  as  they  ever  were,  and  his 
book  can  never  become  obsolete.  But  listen  to  what 
John  Bell  says  of  the  microscope :  — 

"  Philosophers  of  the  last  age  had  been  at  infinite 
pains  to  find  the  ultimate  fibre  of  muscles,  thinking  to 
discover  its  properties  in  its  form ;  but  they  saw  just 
in  proportion  to  the  glasses  which  they  used,  or  to  their 
practice  and  skill  in  that  art,  which  is  now  almost  for- 
saken." * 

n 

Dr.  Bostock's  work,  neglected  as  it  is,  is  one  which 
I  value  very  highly  as  a  really  learned  compilation,  full 

*  Anat.  and  Phys.  of  the  Human  Body,  I.  273. 


24  BOEDER  LINES   OF  KNOWLEDGE 

of  original  references.  But  Dr.  Bostock  says :  "  Much 
as  the  naturalist  has  been  indebted  to  the  microscope, 
by  bringing  into  view  many  beings  of  which  he  could 
not  otherwise  have  ascertained  the  existence,  the  physi- 
ologist has  not  yet  derived  any  great  benefit  from  the 
instrument."  * 

These  are  only  specimens  of  the  manner  in  which 
the  microscope  and  its  results  were  generally  regarded 
by  the  generation  just  preceding  our  own. 

I  have  referred  you  to  the  proper  authorities  for  the 
account  of  those  improvements  which  about  the  year 
1830  rendered  the  compound  microscope  an  efficient 
and  trustworthy  instrument.  It  was  now  for  the  first 
time  that  a  true  general  anatomy  became  possible.  As 
early  as  1816  Treviranus  had  attempted  to  resolve  the 
tissues,  of  which  Bichat  had  admitted  no  less  than 
twenty-one,  into  their  simple  microscopic  elements. 
How  could  such  an  attempt  succeed,  Henle  well 
asks,f  at  a  time  when  the  most  extensively  diffused 
of  all  the  tissues,  the  areolar,  was  not  at  all  under- 
stood ?  All  that  method  could  do  had  been  accom- 
plished by  Bichat  and  his  followers.  It  was  for  the 
optician  to  take  the  next  step.  The  future  of  anatomy 
and  physiology,  as  an  enthusiastic  micrologist  of  the 
time  said,  was  in  the  hands  of  Messrs.  Schieck  and 
Pistor,  famous  opticians  of  Berlin. 

In  those  earlier  days  of  which  I  am  speaking,  all 

*  Physiology,  p.  281. 

f  Anatomie  Generate,  (Trad,  de  Jourdan,)  I.  125. 


IN  MEDICAL  SCIENCE.  25 

the  points  of  minute  anatomy  were  involved  in  obscu- 
rity. Some  found  globules  everywhere,  some  fibres. 
Students  disputed  whether  the  conjunctiva  extended 
over  the  cornea  or  not,  and  worried  themselves  over 
Gaultier  de  Claubry's  stratified  layers  of  the  skin,  or 
Breschet's  blennogenous  and  chromatogenous  organs. 
The  dartos  was  a  puzzle,  the  central  spinal  canal  a 
myth,  the  decidua  clothed  in  fable  as  much  as  the 
golden  fleece.  The  structure  of  bone,  now  so  beauti- 
fully made  out,  —  even  that  of  the  teeth,  in  which 
old  Leeuwenhoek,  peeping  with  his  octogenarian  eyes 
through  the  minute  lenses  wrought  with  his  own  hands, 
had  long  ago  seen  the  "  pipes,"  as  he  called  them,  — 
was  hardly  known  at  all.  The  minute  structure  of  the 
viscera  lay  in  the  mists  of  an  uncertain  microscopic 
vision.  The  intimate  recesses  of  the  animal  system 
were  to  the  students  of  anatomy  what  the  interior  of 
Africa  long  was  to  geographers,  and  the  stories  of 
microscopic  explorers  were  as  much  sneered  at  as  those 
of  Bruce  or  Du  Chaillu,  and  with  better  reason. 

Now  what  have  we  come  to  in  our  own  day  ?  In 
the  first  place,  the  minute  structure  of  all  the  organs 
has  been  made  out  in  the  most  satisfactory  way.  The 
special  arrangements  of  the  vessels  and  the  ducts  of  all 
the  glands,  of  the  air- tubes  and  vesicles  of  the  lungs, 
of  the  parts  which  make  up  the  skin  and  other  mem- 
branes, all  the  details  of  those  complex  parenchymatous 
organs  which  had  confounded  investigation  so  long, 
have  been  lifted  out  of  the  invisible  into  the  sight  of  all 
2 


26  BORDER  LINES   OF  KNOWLEDGE 

observers.  It  is  fair  to  mention  here,  that  we  owe  a 
great  deal  to  the  art  of  minute  injection,  by  which  we 
are  enabled  to  trace  the  smallest  vessels  in  the  midst 
of  the  tissues  where  they  are  distributed.  This  is  an 
old  artifice  of  anatomists.  The  famous  Ruysch,  who 
died  a  hundred  and  thirty  years  ago,  showed  that  each 
of  the  viscera  has  its  terminal  vessels  arranged  in  its 
own  peculiar  way ;  *  the  same  fact  which  you  may  see 
illustrated  in  Gerber's  figures  after  the  minute  injec- 
tions of  Berres.f  I  hope  to  show  you  many  specimens 
of  this  kind  in  the  microscope,  the  work  of  English  and 
American  hands.  Professor  Agassiz  allows  me  also  to 
make  use  of  a  very  rich  collection  of  injected  prepara- 
tions sent  him  by  Professor  Hyrtl,  formerly  of  Prague, 
now  of  Vienna,  for  the  proper  exhibition  of  which  I 
had  a  number  of  microscopes  made  expressly,  by  Mr. 
Grunow,  during  the  past  season.  All  this  illustrates 
what  has  been  done  for  the  elucidation  of  the  intimate 
details  of  formation  of  the  organs. 

But  the  great  triumph  of  the  microscope  as  applied 
to  anatomy  has  been  in  the  resolution  of  the  organs 
and  the  tissues  into  their  simple  constituent  anatomical 
elements.  It  has  taken  up  general  anatomy  where 
Bichat  left  it.  He  had  succeeded  in  reducing  the 
structural  language  of  nature  to  syllables,  if  you  will 
permit  me  to  use  so  bold  an  image.  The  microscopic 
observers  who  have  come  after  him  have  analyzed  these 

*  Haller,  Bibl.  Anat.,  I.  633. 

t  General  and  Minute  Anatomy,  (London,  1842,)  Plate  XXIIL 


EN  MEDICAL   SCIENCE.  27 

into  letters,  as  we  may  call  them, — the  simple  elements 
by  the  combination  of  which  Nature  spells  out  succes- 
sively tissues,  which  are  her  syllables,  organs  which 
are  her  words,  systems  which  are  her  chapters,  and 
so  goes  on  from  the  simple  to  the  complex,  until  she 
binds  up  in  one  living  whole  that  wondrous  volume  of 
power  and  wisdom  which  we  call  the  human  body. 

The  alphabet  of  the  organization  is  so  short  and 
simple,  that  I  will  risk  fatiguing  your  attention  by  re- 
peating it,  according  to  the  plan  I  have  long  adopted. 

A.  Cells,  either  floating,  as  in  the  blood,  or  fixed, 
like  those  in  the  cancellated  structure  of  bone,  already 
referred  to.  Very  commonly  they  have  undergone  a 
change  of  figure,  most  frequently  a  flattening  which 
reduces  them  to  scales,  as  in  the  epidermis  and  the 
epithelium. 

B.  Simple,  translucent,  homogeneous  solid,  such 
as  is  found  at  the  back  of  the  cornea,  or  forming  the 
intercellular  substance  of  cartilage. 

C.  The  white  fibrous  element,  consisting  of  very 
delicate,  tenacious  threads.  This  is  the  long-staple 
textile  substance  of  the  body.  It  is  to  the  organism 
what  cotton  is  pretended  to  be  to  our  Southern  States. 
It  pervades  the  whole  animal  fabric  as  areolar  tissue, 
which  is  the  universal  packing  and  wrapping  material. 
It  forms  the  ligaments  which  bind  the  whole  frame- 
work together.  It  furnishes  the  sinews,  which  are  the 
channels  of  power.  It  enfolds  every  muscle.  It  wraps 
the  brain  in  its  hard,  insensible  folds,  and  the  heart 
itself  beats  in  a  purse  that  is  made  of  it. 


28  BOEDER  LINES   OF  KNOWLEDGE 

D.  The  yellow  elastic,  fibrous  element,  the  caout- 
chouc of  the  animal  mechanism,  which  pulls  things 
back  into  place,  as  the  india-rubber  band  shuts  the 
door  we  have  opened. 

E.  The  striped  muscular  fibre,  —  the  red  flesh, 
which  shortens  itself  in  obedience  to  the  will,  and  thus 
produces  all  voluntary  active  motion. 

F.  The  unstriped  muscular  fibre,  more  properly 
the  fusiform-cell  fibre,  which  carries  on  the  involun- 
tary internal  movements. 

G.  The  nerve-cylinder,  a  glassy  tube,  with  a  pith 
of  some  firmness,  which  conveys  sensation  to  the  brain 
and  the  principle  which  induces  motion  from  it. 

H.  The  nerve-corpuscle,  the  centre  of  nervous 
power. 

I.  The  mucous  tissue,  as  Virchow  calls  it,  common 
in  embryonic  structures,  seen  in  the  vitreous  humor  of 
the  adult. 

To  these  add  X,  granules,  of  indeterminate  shape 
and  size,  Y,  for  inorganic  matters,  such  as  the  salts  of 
bone  and  teeth,  and  Z,  to  stand  as  a  symbol  of  the 
fluids,  and  you  have  the  letters  of  what  I  have  ven- 
tured to  call  the  alphabet  of  the  body. 

But  just  as  in  language  certain  diphthongs  and  syl- 
lables are  frequently  recurring,  so  we  have  in  the  body 
certain  secondary  and  tertiary  combinations,  which  we 
meet  more  frequently  than  the  solitary  elements  of 
which  they  are  composed. 

Thus  A  B,  or  a  collection  of  cells  united  by  simple 


IN  MEDICAL   SCIENCE.  29 

structureless  solid,  is  seen  to  be  extensively  employed 
in  the  body  under  the  name  of  cartilage.  Out  of  this 
the  surfaces  of  the  articulations  and  the  springs  of  the 
breathing  apparatus  are  formed.  But  when  Nature 
came  to  the  buffers  of  the  spinal  column  (interverte- 
bral disks)  and  the  washers  of  the  joints  (semilunar 
fibro-cartilages  of  the  knee,  etc.),  she  required  more 
tenacity  than  common  cartilage  possessed.  What  did 
she  do  ?  What  does  man  do  in  a  similar  case  of  need  ? 
I  need  hardly  tell  you.  The  mason  lays  his  bricks  in 
simple  mortar.  But  the  plasterer  works  some  hair  into 
the  mortar  which  he  is  going  to  lay  in  large  sheets  on 
the  walls.  The  children  of  Israel  complained  that 
they  had  no  straw  to  make  their  bricks  with,  though 
portions  of  it  may  still  be  seen  in  the  crumbling  pyra- 
mid of  Darshour,  which  they  are  said  to  have  built. 
I  visited  the  old  house  on  Witch  Hill  in  Salem  a  year 
or  two  ago,  and  there  I  found  the  walls  coated  with 
clay  in  which  straw  was  abundantly  mingled;  —  the 
old  Judaizing  witch-hangers  copied  the  Israelites  in  a 
good  many  things.  The  Chinese  and  the  Corsicans 
blend  the  fibres  of  amianthus  in  their  pottery  to  give 
it  tenacity.  Now  to  return  to  Nature.  To  make  her 
buffers  and  washers  hold  together  in  the  shocks  to 
which  they  would  be  subjected,  she  took  common  car- 
tilage and  mingled  the  white  fibrous  tissue  with  it,  to 
serve  the  same  purpose  as  the  hair  in  the  mortar,  the 
straw  in  the  bricks  and  in  the  plaster  of  the  old  wall, 
and  the  amianthus  in  the  earthen  vessels.     Thus  we 


30  BORDER  LINES   OF  KNOWLEDGE 

have  the  combination  ABC,  or  fibro-cartilage.  Again, 
the  bones  were  once  only  gristle  or  cartilage,  A  B. 
To  give  them  solidity  they  were  infiltrated  with  stone, 
in  the  form  of  salts  of  lime,  an  inorganic  element,  so 
that  bone  would  be  spelt  out  by  the  letters  A,  B,  and  Y. 
If  from  these  organic  syllables  we  proceed  to  form 
organic  words,  we  shall  find  that  Nature  employs 
three  principal  forms  ;  namely,  Vessels,  Membranes, 
and  Parenchyma,  or  visceral  tissue.  The  most  com- 
plex of  them  can  be  resolved  into  a  combination  of 
these  few  simple  anatomical  constituents. 

Passing  for  a  moment  into  the  domain  of  Pathologi- 
cal Anatomy,  we  find  the  same  elements  in  morbid 
growths  that  we  have  met  with  in  normal  structures. 
The  pus-corpuscle  and  the  white  blood-corpuscle  can 
only  be  distinguished  by  tracing  them  to  their  origin. 
A  frequent  form  of  so-called  malignant  disease  proves 
to  be  only  a  collection  of  altered  epithelium-cells. 
Even  cancer  itself  has  no  specific  anatomical  ele- 
ment, and  the  diagnosis  of  a  cancerous  tumor  by  the 
microscope,  though  tolerably  sure  under  the  eye  of 
an  expert,  is  based  upon  accidental,  and  not  essential 
points,  —  the  crowding  together  of  the  elements,  the 
size  of  the  cell-nuclei,  and  similar  variable  characters. 

Let  us  turn  to  Physiology.  The  microscope,  which 
has  made  a  new  science  of  the  intimate  structure  of 
the  organs,  has  at  the  same  time   cleared   up    many 


IN  MEDICAL   SCIENCE.  31 

uncertainties  concerning  the  mechanism  of  the  special 
functions.  Up  -to  the  time  of  the  living  generation  of 
observers,  Nature  had  kept  over  all  her  inner  work- 
shops the  forbidding  inscription,  No  Admittance!  If 
any  prying  observer  ventured  to  spy  through  his  mag- 
nifying tubes  into  the  mysteries  of  her  glands  and 
canals  and  fluids,  she  covered  up  her  work  in  blinding 
mists  and  bewildering  halos,  as  the  deities  of  old  con- 
cealed their  favored  heroes  in  the  moment  of  danger. 
Science  has  at  length  sifted  the  turbid  light  of  her 
lenses,  and  blanched  their  delusive  rainbows. 

Anatomy  studies  the  organism  in  space.  Physiol- 
ogy studies  it  also  in  time.  After  the  study  of  form 
and  composition  follows  close  that  of  action,  and  this 
leads  us  along  back  to  the  first  moment  of  the  germ, 
and  forward  to  the  resolution  of  the  living  frame  into 
its  lifeless  elements.  In  this  way  Anatomy,  or  rather 
that  branch  of  it  which  we  call  Histology,  has  become 
inseparably  blended  with  the  study  of  function.  The 
connection  between  the  science  of  life  and  that  of  in- 
timate structure  on  the  one  hand,  and  composition  on 
the  other,  is  illustrated  in  the  titles  of  two  recent  works 
of  remarkable  excellence,  —  the  Physiological  Anato- 
my of  Todd  and  Bowman,  and  the  Physiological 
Chemistry  of  Lehmann. 

Let  me  briefly  recapitulate  a  few  of  our  acquisitions 
in  Physiology,  due  in  large  measure  to  our  new  instru- 
ments and  methods  of  research,  and  at  the  same  time 
indicate  the  limits  which  form  the  permanent  or  the 


32  BORDER  LINES   OF  KNOWLEDGE 

temporary  boundaries  of  our  knowledge.  I  will  begin 
with  the  largest  fact  and  with  the  most  absolute  and 
universally  encountered  limitation. 

The  "  largest  truth  in  Physiology  "  Mr.  Paget  con- 
siders to  be  "  the  development  of  ova  through  multi- 
plication and  division  of  their  cells."  I  would  state 
it  more  broadly  as  the  agency  of  the  cell  in  all  living 
processes.  It  seems  at  present  necessary  to  abandon 
the  original  idea  of  Schwann,  that  we  can  observe  the 
building  up  of  a  cell  from  the  simple  granules  of  a 
blastema,  or  formative  fluid.  The  evidence  points 
rather  towards  the  axiom,  Omnis  cellula  e  cellula ; 
that  is,  the  germ  of  a  new  cell  is  always  derived  from 
a  pre-existing  cell.  The  doctrine  of  Schwann,  as  I  re- 
marked long  ago  (1844),  runs  parallel  with  the  nebu- 
lar theory  in  astronomy,  and  they  may  yet  stand  or  fall 
together. 

As  we  have  seen  Nature  anticipating  the  plasterer 
in  fibro-cartilage,  so  we  see  her  beforehand  with  the 
glass-blower  in  her  dealings  with  the  cell.  The  artisan 
blows  his  vitreous  bubbles,  large  or  small,  to  be  used 
afterwards  as  may  be  wanted.  So  Nature  shapes  her 
hyaline  vesicles  and  modifies  them  to  serve  the  needs 
of  the  part  where  they  are  found.  The  artisan  whirls 
his  rod,  and  his  glass  bubble  becomes  a  flattened  disk, 
with  its  bull's-eye  for  a  nucleus.  These  lips  of  ours 
are  all  glazed  with  microscopic  tiles  formed  of  flattened 
cells,  each  one  of  them  with  its  nucleus  still  as  plain 
and  relatively  as  prominent,  to  the  eye  of  the  micro- 


IN  MEDICAL   SCIENCE.  33 

scopist,  as  the  bull's-eye  in  the  old-fashioned  window- 
pane.  Everywhere  we  find  cells,  modified  or  un- 
changed. They  roll  in  inconceivable  multitudes  (five 
millions  and  more  to  the  cubic  millimetre,  according 
to  Vierordt*)  as  blood-disks  through  our  vessels.  A 
close-fitting  mail  of  flattened  cells  coats  our  surface 
with  a  panoply  of  imbricated  scales,  (more  than  twelve 
thousand  millions,  as  Harting  has  computed,!)  as  true 
a  defence  against  our  enemies  as  the  buckler  of  the 
armadillo  or  the  carapace  of  the  tortoise  against  theirs. 
The  same  little  protecting  organs  pave  all  the  great 
highways  of  the  interior  system.  Cells,  again,  preside 
over  the  chemical  processes  which  elaborate  the  living 
fluids ;  they  change  their  form  to  become  the  agents  of 
voluntary  and  involuntary  motion ;  the  soul  itself  sits 
on  a  throne  of  nucleated  cells,  and  flashes  its  mandates 
through  skeins  of  glassy  filaments  which  once  were 
simple  chains  of  vesicles.  And,  as  if  to  reduce  the 
problem  of  living  force  to  its  simplest  expression,  we 
see  the  yolk  of  a  transparent  egg  dividing  itself  in  whole 
or  in  part,  and  again  dividing  and  subdividing,  until  it 
becomes  a  mass  of  cells,  out  of  which  the  harmonious 
diversity  of  the  organs  arranges  itself,  worm  or  man,  as 
God  has  willed  from  the  beginning. 

This  differentiation  having  been  effected,  each  sev- 
eral part  assumes  its  special  office,  having  a  life  of  its 
own,  adjusted  to  that  of  other   parts  and  the  whole. 

*  Kolliker,  Manual,  etc.,  (London,  I860,)  p.  518. 
t  Valentin's  Physiology,  (Brinton's  Transl.,)  p.  13. 

2*  c 


34  BORDER  LINES   OF  KNOWLEDGE 

"  Just  as  a  tree  constitutes  a  mass  arranged  in  a  definite 
manner,  in  which,  in  every  single  part,  in  the  leaves 
as  in  the  root,  in  the  trunk  as  in  the  blossom,  cells  are 
discovered  to  be  the  ultimate  elements,  so  is  it  also  with 
the  forms  of  animal  life.  Every  animal  presents  itself 
as  a  sum  of  vital  unities,  every  one  of  which  manifests 
all  the  characteristics  of  life."* 

The  mechanism  is  as  clear,  as  unquestionable,  as  ab- 
solutely settled  and  universally  accepted,  as  the  order 
of  movement  of  the  heavenly  bodies,  which  we  com- 
pute backward  to  the  days  of  the  observatories  on  the 
plains  of  Shinar,  and  on  the  faith  of  which  we  regulate 
the  movements  of  war  and  trade  by  the  predictious  of 
our  ephemeris. 

The  mechanism,  and  that  is  all.  We  see  the  work- 
man and  the  tools,  but  the  skill  that  guides  the  work 
and  the  power  that  performs  it  are  as  invisible  as  ever. 
I  fear  that  not  every  listener  took  the  significance  of 
those  pregnant  words  in  the  passage  I  quoted  from 
John  Bell,  —  a  thinking  to  discover  its  jproperties  in  its 
form"  We  have  discovered  the  working  bee  in  this 
great  hive  of  organization.  We  have  detected  the  cell 
in  the  very  act  of  forming  itself  from  a  nucleus,  of 
transforming  itself  into  various  tissues,  of  selecting  the 
elements  of  various  secretions.  But  why  one  cell  be- 
comes nerve  and  another  muscle,  why  one  selects  bile 
and  another  fat,  we  can  no  more  pretend  to  tell,  than 
why  one  grape  sucks  out  of  the  soil  the  generous  juice 

*  Virchow,  Cellular  Pathology,  Lect.  I. 


IN  MEDICAL   SCIENCE.  35 

which  princes  hoard  in  their  cellars,  and  another  the 
wine  which  it  takes  three  men  to  drink,  —  one  to  pour 
it  down,  another  to  swallow  it,  and  a  third  to  hold  him 
while  it  is  going  down.  Certain  analogies  between  this 
selecting  power  and  the  phenomena  of  endosmosis  in 
the  elective  affinities  of  chemistry  we  can  find,  but  the 
problem  of  foroe  remains  here,  as  everywhere,  unsolved 
and  insolvable. 

Do  we  gain  anything  by  attempting  to  get  rid  of  the 
idea  of  a  special  vital  force  because  we  find  certain 
mutually  convertible  relations  between  forces  in  the 
body  and  out  of  it  ?  I  think  not,  any  more  than  we 
should  gain  by  getting  rid  of  the  idea  and  expression 
Magnetism  because  of  its  correlation  with  electricity. 
We  may  concede  the  unity  of  all  forms  of  force,  but 
we  cannot  overlook  the  fixed  differences  of  its  manifes- 
tations according  to  the  conditions  under  which  it  acts. 
It  is  a  mistake,  however,  to  think  the  mystery  is  greater 
in  an  organized  body  than  in  any  other.  We  see  a 
stone  fall  or  a  crystal  form,  and  there  is  nothing  stran- 
ger left  to  wonder  at,  for  we  have  seen  the  Infinite  in 
action. 

Just  so  far  as  we  can  recognize  the  ordinary  modes 
of  operation  of  the  common  forces  of  nature,  —  gravity, 
cohesion,  elasticity,  transudation,  chemical  action,  and 
the  rest,  —  we  see  the  so-called  vital  acts  in  the  light  of 
a  larger  range  of  known  facts  and  familiar  analogies. 
Matteucci's  well-remembered  lectures  contain  many 
and  striking  examples  of  the  working  of  physical  forces 


36  BORDER  LINES   OF   KNOWLEDGE 

in  physiological  processes.  Wherever  rigid  experiment 
carries  us,  we  are  safe  in  following  this  lead ;  but  the 
moment  we  begin  to  theorize  beyond  our  strict  observa- 
tion, we  are  in  danger  of  falling  into  those  mechanical 
follies  which  true  science  has  long  outgrown. 

Recognizing  the  fact,  then,  that  we  have  learned 
nothing  but  the  machinery  of  life,  and  are  no  nearer 
to  its  essence,  what  is  it  that  we  have  gained  by  this 
great  discovery  of  the  cell  formation  and  function  ? 

It  would  have  been  reward  enough  to  learn  the 
method  Nature  pursues  for  its  own  sake.  If  the  sov- 
ereign Artificer  lets  us  into  his  own  laboratories  and 
workshops,  we  need  not  ask  more  than  the  privilege 
of  looking  on  at  his  work.  We  do  not  know  where 
we  now  stand  in  the  hierarchy  of  created  intelligences. 
We  were  made  a  little  lower  than  the  angels.  I  speak 
it  not  irreverently ;  as  the  lower  animals  surpass  man 
in  some  of  their  attributes,  so  it  may  be  that  not  every 
angel's  eye  can  see  as  broadly  and  as  deeply  into  the 
material  works  of  God  as  man  himself,  looking  at  the 
firmament  through  an  equatorial  of  fifteen  inches'  aper- 
ture, and  searching  into  the  tissues  with  a  twelfth 
of  an  inch  objective. 

But  there  are  other  positive  gains  of  a  more  practi- 
cal character.  Thus  we  are  no  longer  permitted  to 
place  the  seat  of  the  living  actions  in  the  extreme  ves- 
sels, which  are  only  the  carriers  from  which  each  part 
takes  what  it  wants  by  the  divine  right  of  the  omnipo- 
tent nucleated  cell.     The  organism  has  become,  in  the 


IN   MEDICAL   SCIENCE.  37 

words  already  borrowed  from  Virchow,  "  a  sum  of  vital 
unities."  The  strictum  and  laxum,  the  increased  and 
diminished  action  of  the  vessels,  out  of  which  medical 
theories  and  methods  of  treatment  have  grown  up,  have 
yielded  to  the  doctrine  of  local  cell-communities,  be- 
longing to  this  or  that  vascular  district,  from  which 
they  help  themselves,  as  contractors  are  wont  to  do 
from  the  national  treasury. 

I  cannot  promise  to  do  more  than  to  select  a  few  of 
the  points  of  contact  between  our  ignorance  and  our 
knowledge  which  present  particular  interest  in  the  ex- 
isting state  of  physiological  knowledge.  Some  of  them 
involve  the  microscopic  discoveries  of  which  I  have 
been  speaking,  some  belong  to  the  domain  of  chemistry, 
and  some  have  relations  with  other  departments  of 
physical  science. 

If  we  should  begin  with  the  digestive  function,  we 
should  find  that  the  long-agitated  question  of  the  nature 
of  the  acid  of  the  gastric  juice  is  becoming  settled  in 
favor  of  the  lactic.  But  the  whole  solvent  agency  of 
the  digestive  fluid  enters  into  the  category  of  that  ex- 
ceptional mode  of  action  already  familiar  to  us  in 
chemistry  as  catalysis.  It  is  therefore  doubly  difficult 
of  explanation  ;  first,  as  being,  like  all  reactions,  a  fact 
not  to  be  accounted  for  except  by  the  imaginative  ap- 
peal to  "  affinity,"  and  secondly,  as  being  one  of  those 
peculiar  reactions  provoked  by  an  element  which  stands 
outside  and  looks  on  without  compromising  itself. 

The  doctrine  of  Mulder,  so  widely  diffused  in  popu- 


38  BORDER  LINES   OF   KNOWLEDGE 

lar  and  scientific  belief,  of  the  existence  of  a  common 
base  of  all  albuminous  substances,  the  so-called  protein, 
has  not  stood  the  test  of  rigorous  analysis.  The  divis- 
ion of  food  into  azotized  and  non-azotized  is  no  doubt 
important,  but  the  attempt  to  show  that  the  first  only 
is  plastic  or  nutritive,  while  the  second  is  simply  calori- 
facient,  or  heat-producing,  fails  entirely  in  the  face  of 
the  facts  revealed  by  the  study  of  man  in  different  cli- 
mates, and  of  numerous  experiments  in  the  feeding  of 
animals.  I  must  return  to  this  subject  in  connection 
with  the  respiratory  function. 

The  sugar-making  faculty  of  the  liver  is  another 
"  catalytic  "  mystery,  as  great  as  the  rest  of  them,  and 
no  greater.  Liver-tissue  brings  sugar  out  of  the  blood, 
or  out  of  its  own  substance ;  —  why  ? 

Quia  est  in  eo 
Virtus  saccharitiva. 

Just  what  becomes  of  the  sugar  beyond  the  fact  of  its 
disappearance  before  it  can  get  into  the  general  circula- 
tion and  sweeten  our  tempers,  it  is  hard  to  say. 

The  pancreatic  fluid  makes  an  emulsion  of  the  fat 
contained  in  our  food,  but  just  how  the  fatty  particles 
get  into  the  villi  we  must  leave  Briicke  and  Kolliker  to 
settle  if  they  can. 

No  one  has  shown  satisfactorily  the  process  by  which 
the  blood-corpuscles  are  formed  out  of  the  lymph-cor- 
puscles, nor  what  becomes  of  them.  These  two  ques- 
tions are  like  those  famous  household  puzzles,  —  Where 
do  the  flies  come  from  ?  and,  Where  do  the  pins  go  to  ? 


IN  MEDICAL   SCIENCE.  39 

There  is  a  series  of  organs  in  the  body  which  has 
long  puzzled  physiologists,  —  organs  of  glandular  aspect, 
but  having  no  ducts,  —  the  spleen,  the  thyroid  and 
thymus  bodies,  and  the  suprarenal  capsules.  We  call 
them  vascular  glands,  and  we  believe  that  they  elabo- 
rate colored  and  uncolored  blood-cells  ;  but  just  what 
changes  they  effect,  and  just  how  they  effect  them,  it 
has  proved  a  very  difficult  matter  to  determine.  So  of 
the  noted  glandules  which  form  Peyer's  patches,  their 
precise  office,  though  seemingly  like  those  of  the  lym- 
phatic glands,  cannot  be  positively  assigned,  so  far  as  I 
know,  at  the  present  time.  It  is  of  obvious  interest  to 
learn  it  with  reference  to  the  pathology  of  typhoid  fever. 
It  will  be  remarked  that  the  coincidence  of  their  changes 
in  this  disease  with  enlargement  of  the  spleen  suggests 
the  idea  of  a  similarity  of  function  in  these  two  organs. 

The  theories  of  the  production  of  animal  heat,  from 
the  times  of  Black,  Lavoisier,  and  Crawford  to  those 
of  Liebig,  are  familiar  to  all  who  have  paid  any  atten- 
tion to  physiological  studies.  The  simplicity  of  Liebig's 
views,  and  the  popular  form  in  which  they  have  been 
presented,  have  given  them  wide  currency,  and  incorpo- 
rated them  in  the  common  belief  and  language  of  our 
text-books.  Direct  oxidation  or  combustion  of  the 
carbon  and  hydrogen  contained  in  the  food,  or  in  the 
tissues  themselves  ;  the  division  of  alimentary  sub- 
stances into  respiratory,  or  non-azotized,  and  azotized, — 
these  doctrines  are  familiar  even  to  the  classes  in  our 
high-schools.     But  this  simple  statement  is  boldly  ques- 


40  BORDER  LINES   OF  KNOWLEDGE 

tioned.  Nothing  proves  that  oxygen  combines  (in  the 
system)  with  hydrogen  and  carbon  in  particular,  rather 
than  with  sulphur  and  azote.  Such  is  the  well-grounded 
statement  of  Robin  and  Verdeil.  "  It  is  very  probable 
that  animal  heat  is  entirely  produced  by  the  chemical 
actions  which  take  place  in  the  organism^  but  the  phe- 
nomenon is  too  complex  to  admit  of  our  calculating  it 
according  to  the  quality  of  oxygen  consumed."  These 
last  are  the  words  of  Regnault,  as  cited  by  Mr.  Lewes, 
whose  intelligent  discussion  of  this  and  many  of  the 
most  interesting  physiological  problems  I  strongly  rec- 
ommend to  your  attention. 

This  single  illustration  covers  a  wider  ground  than 
the  special  function  to  which  it  belongs.  We  are  learn- 
ing that  the  chemistry  of  the  body  must  be  studied,  not 
simply  by  its  ingesta  and  egesta,  but  that  there  is  a 
long  intermediate  series  of  changes  which  must  be  in- 
vestigated in  their  own  light,  under  their  own  special 
conditions.  The  expression  "  sum  of  vital  unities " 
applies  to  the  chemical  actions,  as  well  as  to  other 
actions  localized  in  special  parts  ;  and  when  the  dis- 
tinguished chemists  whom  I  have  just  cited  entitle 
their  work  a  treatise  on  the  immediate  principles  of  the 
body,  they  only  indicate  the  nature  of  that  profound 
and  subtile  analysis  which  must  take  the  place  of  all 
hasty  generalizations  founded  on  a  comparison  of  the 
food  with  residual  products. 

I  will  only  call  your  attention  to  the  fact,  that  the 
exceptional  phenomenon  of  the  laboratory  is  the  pre- 


IN  MEDICAL   SCIENCE.  41 

vailing  law  of  the  organism.  Nutrition  itself  is  but  one 
great  catalytic  process.  As  the  blood  travels  its  rounds, 
each  part  selects  its  appropriate  element  and  transforms 
it  to  its  own  likeness.  Whether  the  appropriating  agent 
be  cell  or  nucleus,  or  a  structureless  solid  like  the  in- 
tercellular substance  of  cartilage,  the  fact  of  its  pres- 
ence determines  the  separation  of  its  proper  constitu- 
ents from  the  circulating  fluid,  so  that  even  when  we 
are  wounded  bone  is  replaced  by  bone,  skin  by  skin, 
and  nerve  by  nerve. 

It  is  hardly  without  a  smile  that  we  resuscitate  the 
old  question  of  the  vis  insita  of  the  muscular  fibre,  so 
famous  in  the  discussions  of  Haller  and  his  contempo- 
raries. Speaking  generally,  I  think  we  may  say  that 
Haller's  doctrine  is  the  one  now  commonly  received ; 
namely,  that  the  muscles  contract  in  virtue  of  their 
own  inherent  endowments.  It  is  true  that  Kolliker 
says  no  perfectly  decisive  fact  has  been  brought  for- 
ward to  prove  that  the  striated  muscles  contract  with- 
out having  been  acted  on  by  nerves.  Yet  Mr.  Bow- 
man's observations  on  the  contraction  of  isolated  fibres 
appear  decisive  enough  (unless  we  consider  them  inval- 
idated by  Dr.  Lionel  Beale's  recent  researches,  tending 
to  show  that  each  elementary  fibre  is  supplied  with 
nerves  *)  ;  and  as  to  the  smooth  muscular  fibres,  we 
have  Virchow's  statement  respecting  the  contractility 

*  Proc.  Koyal  Society,  No.  XL.  Vol.  X.,  and  British  and  Foreign  Med. 
Chir.  Review  for  April,  1861. 


42  BORDER  LINES   OF  KNOWLEDGE 

of  those  of  the  umbilical  cord,  where  there  is  not  a 
trace  of  any  nerves.* 

In  the  investigation  of  the  nervous  system,  anatomy 
and  physiology  have  gone  hand  in  hand.  It  is  very 
singular  that  so  important,  and  seemingly  simple,  a 
fact  as  the  connection  of  the  nerve-tubes,  at  their 
origin  or  in  their  course,  with  the  nerve-cells,  should 
have  so  long  remained  open  to  doubt,  as  you  may 
see  that  it  did  by  referring  to  the  very  complete  work 
of  Sharpey  and  Quain,  (edition  of  1849,)  the  histo- 
logical portion  of  which  is  cordially  approved  by  Kol- 
liker  himself.f 

Several  most  interesting  points  of  the  minute  anat- 
omy of  the  nervous  centres  have  been  laboriously 
and  skilfully  worked  out  by  a  recent  graduate  of  this 
Medical  School,  in  a  monograph  worthy  to  stand  in 
line  with  those  of  Lockhart  Clarke,  Stilling,  and 
Schroder  van  der  Kolk.J  I  have  had  the  privilege 
of  examining  and  of  showing  some  of  you  a  number 
of  Dr.  Dean's  skilful  preparations.  I  have  no  space 
to  give  even  an  abstract  of  his   conclusions.      I  can 


*  See  also  the  results  of  experiments  with  woorara  and  sul.phocyanide  of 
potassium.  The  first  destroys  the  irritability  of  the  nerves,  the  second  that 
of  the  muscles.  The  student  will  find  a  notice  of  Bernard's  experiments 
with  these  poisons  in  Dr.  Dal  ton's  standard  work  on  Physiology,  which 
if  he  does  not  own,  he  should  at  once  procure. 

t  See  also  a  learned  note  in  Dr.  Waldo  I.  Burnett's  "  Reviews  and  Ab- 
stracts," etc.,  American  Journal  of  Science,  September,  1853. 

J  Microscopic  Anatomy  of  the  Lumbar  Enlargement  of  the  Spinal  Cord. 
By  John  Dean,  M.  D.     Cambridge.    1861. 


IN  MEDICAL  SCIENCE.  43 

only  refer  to  his  proof  of  the  fact,  that  a  single  cell 
may  send  its  processes  into  several  different  bun- 
dles of  nerve-roots  (Fig.  7,  i?),  and  to  his  demon- 
stration of  the  curved  ascending  and  descending  fibres 
from  the  posterior  nerve-roots,  to  reach  what  he  has 
called  the  longitudinal  columns  of  the  cornua  (Fig. 
8,  h,  K).  I  must  also  mention  Dr.  Dean's  exquisite 
microscopic  photographs  from  sections  of  the  medulla 
oblongata,  which  appear  to  me  to  promise  a  new  de- 
velopment, if  not  a  new  epoch,  in  anatomical  art. 

It  having  been  settled  that  the  nerve-tubes  can 
very  commonly  be  traced  directly  to  the  nerve-cells, 
the  object  of  all  the  observers  in  this  department  of 
anatomy  is  to  follow  these  tubes  to  their  origin.  We 
have  an  infinite  snarl  of  telegraph-wires,  and  we  may 
be  reasonably  sure  that,  if  we  can  follow  them  up,  we 
shall  find  each  of  them  ends  in  a  battery  somewhere. 
One  of  the  most  interesting  problems  is  to  find  the 
ganglionic  origin  of  the  great  nerves  of  the  medulla 
oblongata,  and  this  is  the  end  to  which,  by  the  aid  of 
the  most  delicate  sections,  colored  so  as  to  bring  out 
their  details,  mounted  so  as  to  be  imperishable,  mag- 
nified by  the  best  instruments,  and  now  self-recorded 
in  the  light  of  the  truth-telling  sunbeam,  our  fellow- 
student  is  making  a  steady  progress  in  a  labor  which 
I  think  bids  fair  to  rank  with  the  most  valuable  con- 
tributions to  histology  that  we  have  had  from  this  side 
of  the  Atlantic. 

It  is  interesting  to  see  how  old  questions  are  inci- 


44  BORDER  LINES   OF  KNOWLEDGE 

dentally  settled  in  the  course  of  these  new  investiga- 
tions. Thus,  Mr.  Clarke's  dissections,  confirmed  by- 
preparations  of  Mr.  Dean's  which  I  have  myself  ex- 
amined, place  the  fact  of  the  decussation  of  the  pyra- 
mids—  denied  by  Haller,  by  Morgagni,  and  even  by 
Stilling  —  beyond  doubt.  So  the  spinal  canal,  the  ex- 
istence of  which,  at  least  in  the  adult,  has  been  so  often 
disputed,  appears  as  a  coarse  and  unequivocal  anatomi- 
cal fact  in  many  of  the  preparations  referred  to. 

While  these  studies  of  the  structure  of  the  cord 
have  been  going  on,  the  ingenious  and  indefatigable 
Brown-Se*quard  has  been  investigating  the  functions 
of  its  different  parts  with  equal  diligence.  The  mi- 
croscopic anatomists  had  shown  that  the  ganglionic 
corpuscles  of  the  gray  matter  of  the  cord  are  con- 
nected with  each  other  by  their  processes,  as  well  as 
with  the  nerve-roots.  M.  Brown-Se*quard  has  proved 
by  numerous  experiments  that  the  gray  substance 
transmits  sensitive  impressions  and  muscular  stimula- 
tion. The  oblique  ascending  and  descending  fibres 
from  the  posterior  nerve-roots,  joining  the  "  longitudi- 
nal columns  of  the  cornua,"  *  account  for  the  results 
of  Brown-S6quard's  sections  of  the  posterior  columns.! 
The  physiological  experimenter  has  also  made  it  evi- 
dent that  the  decussation  of  the  conductors  of  sensi- 
tive impressions  has  its  seat  in  the  spinal  cord,  and 
not  in  the  encephalon,  as  had  been  supposed.      Not 

*  Dean's  Memoir,  Fig.  8. 

t  Lectures,  (Philadelphia,  I860,)  Lect.  II.  p.  26,  and  Plate  I.  fig.  7. 


IN  MEDICAL  SCIENCE.  45 

less  remarkable  than  these  results  are  the  facts,  which 
I  with  others  of  my  audience  have  had  the  opportunity 
of  observing,  as  shown  by  M.  Brown-Se'quard,  of  the 
artificial  production  of  epilepsy  in  animals  by  injuring 
the  spinal  cord,  and  the  induction  of  the  paroxysm  by 
pinching  a  certain  portion  of  the  skin.  I  would  also 
call  the  student's  attention  to  his  account  of  the  rela- 
tions of  the  nervous  centres  to  nutrition  and  secre- 
tion, the  last  of  which  relations  has  been  made  the 
subject  of  an  extended  essay  by  our  fellow-country- 
man, Dr.  H.  F.  Campbell,  of  Georgia. 

The  physiology  of  the  spinal  cord  seems  a  simple 
matter  as  you  study  it  in  Longet.  The  experiments 
of  Brown-Se'quard  have  shown  the  problem  to  be 
a  complex  one,  and  raised  almost  as  many  doubts  as 
they  have  solved  questions  ;  at  any  rate,  I  believe  all 
lecturers  on  physiology  agree  that  there  is  no  part  of 
their  task  they  dread  so  much  as  the  analysis  of  the  evi- 
dence relating  to  the  special  offices  of  the  different  por- 
tions of  the  medulla  spinalis.  In  the  brain  we  are  sure 
that  we  do  not  know  how  to  localize  functions ;  in  the 
spinal  cord,  we  think  we  do  know  something ;  but  there 
are  so  many  anomalies,  and  seeming  contradictions,  and 
sources  of  fallacy,  that,  beyond  the  facts  of  crossed  pa- 
ralysis of  sensation,  and  the  conducting*  agency  of  the 
gray  substance,  I  am  afraid  we  retain  no  cardinal 
principles  discovered  since  the  development  of  the 
reflex  function  took  its  place  by  Sir  Charles  Bell's  great 
discovery. 


46  BORDER  LINES   OF   KNOWLEDGE 

By  the  manner  in  which  I  spoke  of  the  brain,  you 
will  see  that  I  am  obliged  to  leave  phrenology  sub 
Jove,  —  out  in  the  cold,  —  as  not  one  of  the  household 
of  science.  I  am  not  one  of  its  haters  ;  on  the  contrary, 
I  am  grateful  for  the  incidental  good  it  has  done.  I 
love  to  amuse  myself  in  its  plaster  Golgothas,  and  listen 
to  the  glib  professor,  as  he  discovers  by  his  manipula- 
tions 

"  All  that  disgraced  my  betters  met  in  me." 

I  loved  of  old  to  see  square-headed,  heavy-jawed  Spurz- 
heim  make  a  brain  flower  out  into  a  corolla  of  marrowy 
filaments,  as  Vieussens  had  done  before  him,  and  to  hear 
the  dry-fibred  but  human-hearted  George  Combe  teach 
good  sense  under  the  disguise  of  his  equivocal  system. 
But  the  pseudo-sciences,  phrenology  and  the  rest,  seem 
to  me  only  appeals  to  weak  minds  and  the  weak  points 
of  strong  ones.  There  is  a  pica  or  false  appetite  in 
many  intelligences  ;  they  take  to  odd  fancies  in  place  of 
wholesome  truth,  as  girls  gnaw  at  chalk  and  charcoal. 
Phrenology  juggles  with  nature.  It  is  so  adjusted 
as  to  soak  up  all  evidence  that  helps  it,  and  shed  all 
that  harms  it.  It  crawls  forward  in  all  weathers,  like 
Richard  Edgeworth's  hygrometer.  It  does  not  stand 
at  the  boundary  of  our  ignorance,  it  seems  to  me,  but 
is  one  of  the  will-o'-the-wisps  of  its  undisputed  central 
domain  of  bog  and  quicksand.  Yet  I  should  not  have 
devoted  so  many  words  to  it,  did  I  not  recognize  the 
light  it  has  thrown  on  human  actions  by  its  study  of 
congenital  organic  tendencies.     Its  maps  of  the  surface 


W  MEDICAL   SCIENCE.  47 

of  the  head  are,  I  feel  sure,  founded  on  a  delusion,  but 
its  studies  of  individual  character  are  always  interesting 
and  instructive. 

The  "  snapping-turtle "  strikes  after  its  natural 
fashion  when  it  first  comes  out  of  the  egg.  Children 
betray  their  tendencies  in  their  way  of  dealing  with 
the  breasts  that  nourish  them ;  nay,  I  can  venture  to 
affirm,  that  long  before  they  are  born  they  teach  their 
mothers  something  of  their  turbulent  or  quiet  tempers. 

u  Castor  gaudet  equis,  ovo  prognatus  eodem 
Pugnis." 

Strike  out  the  false  pretensions  of  phrenology ;  call  it 
anthropology  ;  let  it  study  man  the  individual  in  distinc- 
tion from  man  the  abstraction,  the  metaphysical  or  the- 
ological lay-figure ;  and  it  becomes  "  the  proper  study 
of  mankind,"  one  of  the  noblest  and  most  interesting 
of  pursuits. 

The  whole  physiology  of  the  nervous  system,  from 
the  simplest  manifestation  of  its  power  in  an  insect  up 
to  the  supreme  act  of  the  human  intelligence  working 
through  the  brain,  is  fall  of  the  most  difficult  yet  pro- 
foundly interesting  questions.  The  singular  relations 
between  electricity  and  nerve-force,  —  relations  which 
it  has  been  attempted  to  interpret  as  meaning  identity, 
in  the  face  of  palpable  differences,  require  still  more 
extended  studies.  You  may  be  interested  by  Professor 
Faraday's  statement  of  his  opinion  on  the  matter. 
"  Though  I  am  not  satisfied  that  the  nervous  fluid  is 
only   electricity,  still    I    think   that   the  agent  in  the 


48  BORDER  LINES   OF  KNOWLEDGE 

nervous  system  may  be  an  inorganic  force  ;  and  if 
there  be  reason  for  supposing  that  magnetism  is  a 
higher  relation  of  force  than  electricity,  so  it  may 
well  be  imagined  that  the  nervous  power  may  be  of 
a  still  more  exalted  character,  and  yet  within  the  reach 
of  experiment." 

In  connection  with  this  statement,  it  is  interesting  to 
refer  to  the  experiments  of  Helmholtz  on  the  rapidity 
of  transmission  of  the  nervous  actions.  The  rate  is 
given  differently  in  Valentin's  report  of  these  experi- 
ments and  in  that  found  in  the  Scientific  Annual  for 
1858.  One  hundred  and  eighty  to  three  hundred  feet 
per  second  is  the  rate  of  movement  assigned  for  sen- 
sation, but  all  such  results  must  be  very  vaguely 
approximative.  Boxers,  fencers,  players  at  the  Italian 
game  of  mora,  "  prestidigitators,"  and  all  who  depend 
for  their  success  on  rapidity  of  motion,  know  what  dif- 
ferences there  are  in  the  personal  equation  of  move- 
ment. 

Keflex  action,  the  mechanical  sympathy,  if  I  may  so 
call  it,  of  distant  parts  ;  Instinct,  which  is  crystallized 
intelligence, — an  absolute  law  with  its  invariable  planes 
and  angles  introduced  into  the  sphere  of  conscious- 
ness, as  raphides  are  enclosed  in  the  living  cells  of 
plants  ;  Intellect,  —  the  operation  of  the  thinking  prin- 
ciple through  material  organs,  with  an  appreciable 
waste  of  tissue  in  every  act  of  thought,  so  that  our 
clergymen's  blood  has  more  phosphates  to  get  rid  of 
on    Monday  than    on    any  other    clay  of   the    week; 


IN  MEDICAL   SCIENCE  49 

Will,  —  theoretically  the  absolute  determining  power, 
practically  limited  in  different  degrees  by  the  varying 
organization  of  races  and  individuals,  annulled  or  per- 
verted by  different  ill-understood  organic  changes ;  — 
on  all  these  subjects  our  knowledge  is  in  its  infancy, 
and  from  the  study  of  some  of  them  the  interdict  of 
the  Vatican  is  hardly  yet  removed. 

I  must  allude  to  one  or  two  points  in  the  histology 
and  physiology  of  the  organs  of  sense.  The  anterior 
continuation  of  the  retina  beyond  the  ora  serrata  has 
been  a  subject  of  much  discussion.  If  H.  Miiller 
and  Kolliker  can  be  relied  upon,  this  question  is  set- 
tled by  recognizing  that  a  layer  of  cells,  continued 
from  the  retina,  passes  over  the  surface  of  the  zonula 
Zinnii,  but  that  no  proper  nervous  element  is  so  pro- 
longed forward. 

I  observe  that  Kolliker  calls  the  true  nervous  ele- 
ments of  the  retina  "  the  layer  of  gray  cerebral  sub- 
stance." In  fact,  the  ganglionic  corpuscles  of  each 
eye  may  be  considered  as  constituting  a  little  brain, 
connected  with  the  masses  behind  by  the  commissure, 
commonly  called  the  optic  nerve.  We  are  prepared, 
therefore,  to  find  these  two  little  brains  in  the  most 
intimate  relations  with  each  other,  as  we  find  the 
cerebral  hemispheres.  We  know  that  they  are  di- 
rectly connected  by  fibres  that  arch  round  through 
the  chiasma. 

I  mention  these  anatomical  facts  to  introduce  a 
physiological  observation  of  my  own,  first  announced 


50  BORDER   LINES   OF  KNOWLEDGE 

in  one  of  the  lectures  before  the  Medical  Class,  sub- 
sequently communicated  to  the  American  Academy 
of  Arts  and  Sciences,  and  printed  in  its  "  Transac- 
tions "  for  February  14,  1860.  I  refer  to  the  appar- 
ent transfer  of  impressions  from  one  retina  to  the  other, 
to  which  I  have  given  the  name  reflex  vision.  The 
idea  was  suggested  to  me  in  consequence  of  certain 
effects  noticed  in  employing  the  stereoscope.  Profes- 
sor William  B.  Rodgers  has  since  called  the  attention 
of  the  American  Scientific  Association  to  some  facts 
bearing  on  the  subject,  and  to  a  very  curious  experi- 
ment of  Leonardo  da  Vinci's,  which  enables  the  ob- 
server to  look  through  the  palm  of  his  hand  (or  seem 
to),  as  if  it  had  a  hole  bored  through  it.  As  he  and 
others  hesitated  to  accept  my  explanation,  I  was  not 
sorry  to  find  recently  the  following  words  in  the  "  Ob- 
servations on  Man  "  of  that  acute  observer  and  thinker, 
David  Hartley.* 

"  An  impression  made  on  the  right  eye  alone  by  a 
single  object  may*  propagate  itself  into  the  left,  and 
there  raise  up  an  image  almost  equal  in  vividness  to 
itself;  and  consequently  when  we  see  with  one  eye 
only,  we  may,  however,  have  pictures  in  both  eyes." 
Hartley,  in  1784,  had  anticipated  many  of  the  doctrines 
which  have  since  been  systematized  into  the  theory 
of  reflex  actions,  and  with  which  I  have  attempted 
to  associate  this  act  of  reflex  vision.  My  sixth  ex- 
periment, however,  in  the  communication  referred  to, 

*  Vol.  I.  p.  207.    London,  1801. 


IN  MEDICAL   SCIENCE.  51 

appears  to  me  to  be  a  crucial  one,  proving  the  cor- 
rectness of  my  explanation,  and  I  am  not  aware  that  it 
has  been  before  instituted. 

Another  point  of  great  interest  connected  with  the 
physiology  of  vision,  and  involved  for  a  long  time  in 
great  obscurity,  is  that  of  the  adjustment  of  the  eye  to 
different  distances.  Dr.  Clay  Wallace,  of  New  York, 
who  published  a  very  ingenious  little  book  on  the  eye 
about  twenty  years  ago,  with  vignettes  reminding  one 
of  Bewick,  was  among  the  first,  if  not  the  first,  to  de- 
scribe the  ciliary  muscle,  to  which  the  power  of  adjust- 
ment is  generally  ascribed.  It  is  ascertained,  by  exact 
experiment  with  the  phcenidoscope,  that  accommodation 
depends  on  change  of  form  of  the  crystalline  lens. 
Where  the  crystalline  is  wanting,  as  Mr.  Ware  long 
ago  taught,  no  power  of  accommodation  remains.  The 
ciliary  muscle  is  generally  thought  to  effect  the  change 
of  form  of  the  crystalline.  The  power  of  accommoda- 
tion is  lost  after  the  application  of  atropine,  in  conse- 
quence, as  is  supposed,  of  the  paralysis  of  this  muscle. 
This,  I  believe,  is  the  nearest  approach  to  a  demon- 
stration we  have  on  this  point. 

I  have  only  time  briefly  to  refer  to  Professor  Draper's 
most  ingenious  theory  as  to  the  photographic  nature  of 
vision,  for  an  account  of  which  I  must  refer  to  his 
original  and  interesting  Treatise  on  Physiology. 

It  were  to  be  wished  that  the  elaborate  and  very 
interesting  researches  of  the  Marquis  Corti,  which  have 
revealed  such  singular  complexity  of  structure  in  the 


52  BORDER  LINES   OF  KNOWLEDGE 

cochlea  of  the  ear,  had  done  more  to  clear  up  its  doubt- 
ful physiology ;  but  I  am  afraid  we  have  nothing  but 
hypotheses  for  the  special  part  it  plays  in  the  act  of 
hearing,  and  that  we  must  say  the  same  respecting  the 
office  of  the  semicircular  canals. 

The  microscope  has  achieved  some  of  its  greatest 
triumphs  in  teaching  us  the  changes  which  occur  in  the 
development  of  the  embryo.  No  more  interesting  dis- 
covery stands  recorded  in  the  voluminous  literature  of 
this  subject  than  the  one  originally  announced  by  Mar- 
tin Barry,  afterwards  discredited,  and  still  later  con- 
firmed by  Mr.  Newport  and  others ;  namely,  the  fact 
that  the  fertilizing  filament  reaches  the  interior  of  the 
ovum  in  various  animals ;  —  a  striking  parallel  to  the 
action  of  the  pollen-tube  in  the  vegetable.  But  beyond 
the  mechanical  facts  all  is  mystery  in  the  movements 
of  organization,  as  profound  as  in  the  fall  of  a  stone  or 
the  formation  of  a  crystal. 

To  the  chemist  and  the  microscopist  the  living  body 
presents  the  same  difficulties,  arising  from  the  fact  that 
everything  is  in  perpetual  change  in  the  organism.  The 
fibrine  of  the  blood  puzzles  the  one  as  much  as  its  glob- 
ules puzzle  the  other.  The  difference  between  the 
branches  of  science  which  deal  with  space  only,  and 
those  which  deal  with  space  and  time,  is  this  :  we  have 
no  glasses  that  can  magnify  time.  The  figure  I  here 
show  you*  was  photographed  from  an  object  (pleuro- 

•  From  a  very  interesting  paper  by  Professor  0.  N.  Rood,  of  Albany, 
containing,  with  other  views,  the  first  microscopic  stereograph  I  have  seen. 


IN  MEDICAL   SCIENCE.  53 

sigma  angulatum)  magnified  a  thousand  diameters,  or 
presenting  a  million  times  its  natural  surface.  This 
other  figure  of  the  same  object,  enlarged  from  the  one 
just  shown,  is  magnified  seven  thousand  diameters,  or 
forty-nine  million  times  in  surface.  When  we  can 
make  the  forty-nine  millionth  of  a  second  as  long  as 
its  integer,  physiology  and  chemistry  will  approach 
nearer  the  completeness  of  anatomy. 

Our  reverence  becomes  more  worthy,  or,  if  you  will, 
less  unworthy  of  its  Infinite  Object  in  proportion  as 
our  intelligence  is  lifted  and  expanded  to  a  higher  and 
broader  understanding  of  the  Divine  methods  of  action. 
If  Galen  called  his  heathen  readers  to  admire  "  the 
power,  the  wisdom,  the  providence,  the  goodness  of  the 
Framer  of  the  animal  body,"  —  if  Mr.  Boyle,  the  stu- 
dent of  nature,  as  Addison  and  that  friend  of  his  who 
had  known  him  for  forty  years  tell  us,  never  uttered 
the  name  of  the  Supreme  Being  without  making  a  dis- 
tinct pause  in  his  speech,  in  token  of  his  devout  recog- 
nition of  its  awful  meaning,  —  surely  we,  who  inherit 
the  accumulated  wisdom  of  nearly  two  hundred  years 
since  the  time  of  the  British  philosopher,  and  of  almost 
two  thousand  since  the  Greek  physician,  may  well  lift 
our  thoughts  from  the  works  we  study  to  their  great 
Artificer.  These  wonderful  discoveries  which  we  owe 
to  that  mighty  little  instrument,  the  telescope  of  the 
inner  firmament  with  all  its  included  worlds  ;  these 
simple  formulae  by  which  we  condense  the  observations 


54  BORDER  LINES   OF  KNOWLEDGE 

of  a  generation  in  a  single  axiom ;  these  logical  analy- 
ses by  which  we  fence  out  the  ignorance  we  cannot  re- 
claim, and  fix  the  limits  of  our  knowledge,  —  all  lead  us 
up  to  the  inspiration  of  the  Almighty,  which  gives  under- 
standing to  the  world's  great  teachers.  To  fear  science 
or  knowledge,  lest  it  disturb  our  old  beliefs,  is  to  fear 
the  influx  of  the  Divine  wisdom  into  the  souls  of  our 
fellow-men ;  for  what  is  science  but  the  piecemeal 
revelation  —  uncovering  —  of  the  plan  of  creation,  by 
the  agency  of  those  chosen  prophets  of  nature  whom 
God  has  illuminated  from  the  central  light  of  truth 
for  that  single  purpose  ? 

The  studies  which  we  have  glanced  at  are  prelim- 
inary in  your  education  to  the  practical  arts  which 
make  use  of  them,  —  the  arts  of  healing,  —  surgery 
and  medicine.  The  more  you  examine  the  structure 
of  the  organs  and  the  laws  of  life,  the  more  you  will 
find  how  resolutely  each  of  the  cell-republics  which 
make  up  the  E  pluribus  unum  of  the  body  maintains 
its  independence.  Guard  it,  feed  it,  air  it,  warm  it, 
exercise  or  rest  it  properly,  and  the  working  elements 
will  do  their  best  to  keep  well  or  to  get  well.  What  do 
we  do  with  ailing  vegetables  ?  Dr.  Warren,  my  hon- 
ored predecessor  in  this  chair,  bought  a  country-place, 
including  half  of  an  old  orchard.  A  few  years  after- 
wards I  saw  the  trees  on  his  side  of  the  fence  looking 
in  good  health,  while  those  on  the  other  side  were 
scraggy  and   miserable.      How   do   you   suppose   this 


IN  MEDICAL   SCIENCE.  55 

change  was  brought  about  ?  By  watering  them  with 
Fowler's  solution  ?  By  digging  in  calomel  freely  about 
their  roots  ?  Not  at  all ;  but  by  loosening  the  soil 
round  them,  and  supplying  them  with  the  right  kind 
of  food  in  fitting  quantities. 

Now  a  man  is  not  a  plant,  or,  at  least,  he  is  a  very 
curious  one,  for  he  carries  his  soil  in  his  stomach, 
which  is  a  kind  of  portable  flower-pot,  and  he  grows 
round  it,  instead  of  out  of  it.  He  has,  besides,  a  singu- 
larly complex  nutritive  apparatus  and  a  nervous  sys- 
tem. But  recollect  the  doctrine  already  enunciated 
in  the  language  of  Virchow,  that  an  animal,  like 
a  tree,  is  a  sum  of  vital  unities,  of  which  the  cell  is 
the  ultimate  element.  Every  healthy  cell,  whether 
in  a  vegetable  or  an  animal,  necessarily  performs  its 
function  properly  so  long  as  it  is  supplied  with  its 
proper  materials  and  stimuli.  A  cell  may,  it  is  true, 
be  congenitally  defective,  in  which  case  disease  is,  so 
to  speak,  its  normal  state.  But  if  originally  sound 
and  subsequently  diseased,  there  has  certainly  been 
some  excess,  deficiency,  or  wrong  quality  in  the  mate- 
rials or  stimuli  applied  to  it.  You  remove  this  inju- 
rious influence  and  substitute  a  normal  one  ;  remove 
the  baked  coal-ashes,  for  instance,  from  the  roots  of 
a  tree,  and  replace  them  with  loam  ;  take  away  the 
salt  meat  from  the  patient's  table,  and  replace  it  with 
fresh  meat  and  vegetables,  and  the  cells  of  the  tree 
or  the  man  return  to  their  duty. 

I  do  not  know  that  we  ever  apply  to  a  plant  any 


56  BOEDER  LINES   OF   KNOWLEDGE 

element  which  is  not  a  natural  constituent  of  the 
vegetable  structure,  except  perhaps  externally,  for  the 
accidental  purpose  of  killing  parasites.  The  whole 
art  of  cultivation  consists  in  learning  the  proper  food 
and  conditions  of  plants,  and  supplying  them.  We 
give  them  water,  earths,  salts  of  various  kinds  such 
as  they  are  made  of,  with  a  chance  to  help  themselves 
to  air  and  light.  The  farmer  would  be  laughed  at 
who  undertook  to  manure  his  fields  or  his  trees  with 
a  salt  of  lead  or  of  arsenic.  These  elements  are  not 
constituents  of  healthy  plants.  The  gardener  uses  the 
waste  of  the  arsenic  furnaces  to  kill  the  weeds  in  his 
walks. 

If  the  law  of  the  animal  cell,  and  of  the  animal 
organism,  which  is  built  up  of  such  cells,  is  like  that 
of  the  vegetable,  we  might  expect  that  we  should  treat 
all  morbid  conditions  of  any  of  the  vital  unities  be- 
longing to  an  animal  in  the  same  way,  by  increasing, 
diminishing,  or  changing  its  natural  food  or  stimuli. 

"  That  is  an  aliment  which  nourishes  ;  whatever  we 
find  in  the  organism,  as  a  constant  and  integral  ele- 
ment, either  forming  part  of  its  structure,  or  one  of 
the  conditions  of  vital  processes,  that  and  that  only 
deserves  the  name  of  aliment."  *  I  see  no  reason, 
therefore,  why  iron,  phosphate  of  lime,  sulphur,  should 
not  be  considered  food  for  man,  as  much  as  guano  or 
poudrette  for  vegetables.  Whether  one  or  another  of 
them  is  best  in  any  given  case,  —  whether  they  shall 

*  Lewes,  Physiology  of  Common  Life,  I.  76. 


IN  MEDICAL  SCIENCE.  57 

be  taken  alone  or  in  combination,  in  large  or  small 
quantities,  —  are  separate  questions.  But  they  are 
elements  belonging  to  the  body,  and  even  in  mod- 
erate excess  will  produce  little  disturbance.  There 
is  no  presumption  against  any  of  this  class  of  sub- 
stances, any  more  than  against  water  or  salt,  provided 
they  are  used  in  fitting  combinations,  proportions,  and 
forms. 

But  when  it  comes  to  substances  alien  to  the  healthy 
system,  which  never  belong  to  it  as  normal  constitu- 
ents, the  case  is  very  different.  There  is  a  presumption 
against  putting  lead  or  arsenic  into  the  human  body, 
as  against  putting  them  into  plants,  because  they  do 
not  belong  there,  any  more  than  pounded  glass,  which, 
it  is  said,  used  to  be  given  as  a  poison.  The  same 
thing  is  true  of  mercury  and  silver.  What  becomes 
of  these  alien  substances  after  they  get  into  the  system 
we  cannot  always  tell.  But  in  the  case  of  silver,  from 
the  accident  of  its  changing  color  under  the  influence 
of  light,  we  do  know  what  happens.  It  is  thrown 
out,  in  part  at  least,  under  the  epidermis,  and  there 
it  remains  to  the  patient's  dying  day.  This  is  a  strik- 
ing illustration  of  the  difficulty  which  the  system  finds 
in  dealing  with  non-assimilable  elements,  and  justifies 
in  some  measure  the  vulgar  prejudice  against  "  min- 
eral poisons." 

I  trust  the  youngest  student  on  these  benches  will 
not  commit  the  childish  error  of  confounding  a  pre- 
sumption against  a  particular  class  of  agents  with  a 
3* 


58  BORDER  LINES   OF  KNOWLEDGE 

condemnation  of  them.  Mercury,  for  instance,  is  alien 
to  the  system,  and  eminently  disturbing  in  its  influence. 
Yet  its  efficacy  in  certain  forms  of  specific  disease  is 
acknowledged  by  all  but  the  most  sceptical  theorists. 
Even  the  esprit  rnoqueur  of  Ricord,  the  Voltaire  of 
pelvic  literature,  submits  to  the  time-honored  consti- 
tutional authority  of  this  great  panacea  in  the  class  of 
cases  to  which  he  has  devoted  his  brilliant  intelligence. 
Still,  there  is  no  telling  what  evils  have  arisen  from  the 
abuse  of  this  mineral.  Dr.  Armstrong  long  ago  pointed 
out  some  of  them,  and  they  have  become  matters  of 
common  notoriety.  I  am  pleased,  therefore,  when  I 
find  so  able  and  experienced  a  practitioner  as  Dr.  Wil- 
liams of  this  city  proving  that  iritis  is  best  treated  with- 
out mercury,*  and  Dr.  Vanderpool  showing  the  same 
thing  to  be  true  for  pericarditis. 

Whatever  elements  nature  does  not  introduce  into 
vegetables,  the  natural  food  of  all  animal  life, — directly 
of  herbivorous,  indirectly  of  carnivorous  animals,  —  are 
to  be  regarded  with  suspicion.  Arsenic-eating  may 
seem  to  improve  the  condition  of  horses  for  a  time,  — 
and  even  of  human  beings,  if  Tschudi's  stories  can  bo 
trusted,  —  but  it  soon  appears  that  its  alien  qualities  are 
at  war  with  the  animal  organization.  So  of  copper,  an- 
timony, and  other  non-alimentary  simple  substances ; 
every  one  of  them  is  an  intruder  in  the  living  system, 
as  much  as  a  constable  would  be,  quartered  in  our 
household.     This  does  not  mean  that  they  may  not, 

*  On  the  Treatment  of  Iritis  without  Mercury,  Boston,  1856. 


LN  MEDICAL   SCIENCE.  59 

any  of  them,  be  called  in  for  a  special  need,  as  we  send 
for  the  constable  when  we  have  good  reason  to  think 
we  have  a  thief  under  our  roof;  but  a  man's  body  is 
his  castle,  as  well  as  his  house,  and  the  presumption  is 
that  we  are  to  keep  our  alimentary  doors  bolted  against 
these  perturbing  agents. 

Now  the  feeling  is  very  apt  to  be  just  contrary  to  this. 
The  habit  has  been  very  general  with  well-taught  prac- 
titioners, to  have  recourse  to  the  introduction  of  these 
alien  elements  into  the  system  on  the  occasion  of  any 
slight  disturbance.  The  tongue  was  a  little  coated, 
and  mercury  must  be  given ;  the  skin  was  a  little  dry, 
and  the  patient  must  take  antimony.  It  was  like  send- 
ing for  the  constable  and  the  posse  comitatus  when 
there  is  only  a  carpet  to  shake  or  a  refuse-barrel  to 
empty.*  The  constitution  bears  slow  poisoning  a  great 
deal  better  than  might  be  expected  ;  yet  the  most  intel- 
ligent men  in  the  profession  have  gradually  got  out  of 
the  habit  of  prescribing  these  powerful  alien  substances 
in  the  old  routine  way.  Mr.  Metcalf  will  tell  you  how 
much  more  sparingly  they  are  given  by  our-  practitioners 
at  the  present  time,  than  when  he  first  inaugurated  the 
new  era  of  pharmacy  among  us.  Still,  the  presumption 
in  favor  of  poisoning  out  every  spontaneous  reaction  of 
outraged  nature  is  not  extinct  in  those  who  are  trusted 

*  Dr.  James  Johnson  advises  persons  not  ailing  to  take  five  grains  of 
blue  pill  with  one  or  two  of  aloes  twice  a  week  for  three  or  four  months  in 
the  year,  with  half  a  pint  of  compound  decoction  of  sarsaparilla  every  day 
for  the  same  period,  to  preserve  health  a,nd  prolong  life.  Pract.  Treatise  on 
Dis.  of  Liver,  etc.,  p.  272. 


60  BORDER  LINES   OF   KNOWLEDGE 

with  the  lives  of  their  fellow-citizens.  "  On  examining 
the  file  of  prescriptions  at  the  hospital,  I  discovered 
that  they  were  rudely  written,  and  indicated  a  treat- 
ment, as  they  consisted  chiefly  of  tartar  emetic,  ipe- 
cacuanha, and  epsom  salts,  hardly  favorable  to  the  cure 
of  the  prevailing  diarrhoea  and  dysenteries."  *  In  a 
report  of  a  poisoning  case  now  on  trial,  where  we  are 
told  that  arsenic  enough  was  found  in  the  stomach  to 
produce  death  in  twenty-four  hours,  the  patient  is  said 
to  have  been  treated  by  arsenic,  phosphorus,  bryonia, 
aconite,  nux  vomica,  and  muriatic  acid,  —  by  a  prac- 
titioner of  what  school  may  be  imagined. 

The  traditional  idea  of  always  poisoning  out  disease, 
as  we  smoke  out  vermin,  is  now  seeking  its  last  refuge 
behind  the  wooden  cannon  and  painted  port-holes  of 
that  unblushing  system  of  false  scientific  pretences 
which  I  do  not  care  to  name  in  a  discourse  addressed 
to  an  audience  devoted  to  the  study  of  the  laws  of 
nature  in  the  light  of  the  laws  of  evidence.  It  is  ex- 
traordinary to  observe  that  the  system  which,  by  its 
reducing  medicine  to  a  name  and  a  farce,  has  accus- 
tomed all  who  have  sense  enough  to  see  through  its 
thin  artifices  to  the  idea  that  diseases  get  well  with- 
out being  "  cured,"  should  now  be  the  main  support 
of  the  tottering  poison-cure  doctrine.  It  has  unques- 
tionably helped  to  teach  wise  people  that  nature  heals 
most  diseases  without  help  from  pharmaceutic  art,  but 

*  United  States  Sanitary  Commission,  Document  No.  25.    Report  on  a 
Regiment  near  Washington,  dated  July  9th,  1861. 


W  MEDICAL  SCIENCE.  61 

it  continues  to  persuade  fools  that  art  can  arrest  them 
all  with  its  specifics. 

It  is  worse  than  useless  to  attempt  in  any  way  to 
check  the  freest  expression  of  opinion  as  to  the  effi- 
cacy of  any  or  all  of  the  "  heroic  "  means  of  treatment 
employed  by  practitioners  of  different  schools  and  pe- 
riods. Medical  experience  is  a  great  thing,  but  we 
must  not  forget  that  there  is  a  higher  experience,  which 
tries  its  results  in  a  court  of  a  still  larger  jurisdiction ; 
that,  namely,  in  which  the  laws  of  human  belief  are 
summoned  to  the  witness-box,  and  obliged  to  testify  to 
the  sources  of  error  which  beset  the  medical  practi- 
tioner. The  verdict  is  as  old  as  the  father  of  medicine, 
who  announces  it  in  the  words,  "judgment  is  difficult." 
Physicians  differed  so  in  his  time,  that  some  denied 
that  there  was  any  such  thing  as  an  art  of  medicine. 
One  man's  best  remedies  were  held  as  mischievous  by 
another.  The  art  of  healing  was  like  soothsaying,  so 
the  common  people  said  ;  the  same  bird  was  lucky  or 
unlucky,  according  as  he  flew  to  the  right  or  left.* 

The  practice  of  medicine  has  undergone  great  chan- 
ges within  the  period  of  my  own  observation.  Vene- 
section, for  instance,  has  so  far  gone  out  of  fashion, 
that,  as  I  am  told  by  residents  of  the  New  York 
Bellevue  and  the  Massachusetts  General  Hospitals, 
it  is  almost  obsolete  in  these  institutions,  at  least  in 
medical   practice.f      The    old    Brunonian   stimulating 

*  ETepi  Aiairrjs  'O^cW,  §  IV.  v. 

t  A  similar  change  has  taken  place  also  in  English  surgical  practice. 
Sir  W.  Napier  speaks  of  "  that  inveterate  use  of  the  lancet,  which  dis- 


62  BORDER   LINES   OF   KNOWLEDGE 

treatment  has  come  into  vogue  again  in  the  practice 
of  Dr.  Todd  and  his  followers.  The  compounds 
of  mercury  have  yielded  their  place  as  drugs  of  all 
work,  and  specifics  for  that  very  frequent  subjective 
complaint,  nescio  quid  faciam  —  to  compounds  of  io- 
dine.* Opium  is  believed  in,  and  quinine,  and  "rum," 
using  that  expressive  monosyllable  to  mean  all  alco- 
holic cordials.  If  MoliSre  were  writing  now,  instead 
of  saignare,  purgare,  and  the  other,  he  would  be  more 
like  to  say,  Stimulare^  opium  dare  et  potassio-iodizare. 
I  have  been  in  relation  successively  with  the  Eng- 
lish and  American  evacuant  and  alterative  practice,  in 
which  calomel  and  antimony  figured  so  largely  that, 
as  you  may  see  in  Dr.  Jackson's  last  "  Letter,"  Dr. 
Holyoke,  a  good  representative  of  sterling  old-fash- 
ioned medical  art,  counted  them  with  opium  and  Pe- 
ruvian bark  as  his  chief  remedies  ;  with  the  moderately 
expectant  practice  of  Louis ;  the  blood-letting  "  coup 
mr  coup  "  of  Bouillaud ;  the  contra-stimulant  method 
of  Rasori  and  his  followers  ;  the  anti-irritant  system 
of  Broussais,  with  its  leeching  and  gum- water ;  I  have 
heard  from  our  own  students  of  the  simple  opium 
practice  of  the  renowned  German  teacher,  Oppolzer  ; 
and  now  I  find  the  medical  community  brought  round 
by  the  revolving  cycle  of  opinion  to  that  same   old 

graced  the  surgery  of  the  times,"  —  the  early  years  of  this  century.  Life 
and  Opinions  of  Sir  Charles  James  Napier,  (London,  1857,)  Vol.  I.  p.  153. 
*  Sir  Astley  Cooper  has  the  boldness  —  or  honesty  —  to  speak  of  medi- 
cines which  "  are  given  as  much  to  assist  the  medical  man  as  his  patient." 
Lectures,  (London,  1832,)  p.  14. 


m  MEDICAL  SCIENCE.  bd 

plan  of  treatment  which  John  Brown  taught  in  Edin- 
burgh in  the  last  quarter  of  the  last  century,  and 
Miner  and  Tully  fiercely  advocated  among  ourselves 
in  the  early  years  of  the  present.  The  worthy  physi- 
cians last  mentioned,  and  their  antagonist,  Dr.  Gallup, 
used  stronger  language  than  we  of  these  degenerate 
days  permit  ourselves.  "  The  lancet  is  a  weapon 
which  annually  slays  more  than  the  sword,"  says  Dr. 
Tully.  "  It  is  probable  that,  for  forty  years  past,  opium 
and  its  preparations  have  done  seven  times  the  injury 
they  have  rendered  benefit,  on  the  great  scale  of  the 
world,"  says  Dr.  Gallup. 

What  is  the  meaning  of  these  perpetual  changes 
and  conflicts  of  medical  opinion  and  practice,  from  an 
early  antiquity  to  our  own  time  ?  Simply  this  :  all 
"  methods "  of  treatment  end  in  disappointment  of 
those  extravagant  expectations  which  men  are  wont 
to  entertain  of  medical  art.  The  bills  of  mortality 
are  more  obviously  affected  by  drainage,  than  by  this 
or  that  method  of  practice.  The  insurance  compa- 
nies do  not  commonly  charge  a  different  percentage 
on  the  lives  of  the  patients  of  this  or  that  physician. 
In  the  course  of  a  generation,  more  or  less,  physicians 
themselves  are  liable  to  get  tired  of  a  practice  which 
has  so  little  effect  upon  the  average  movement  of  vital 
decomposition.  Then  they  are  ready  for  a  change, 
even  if  it  were  back  again  to  a  method  which  has 
already  been  tried,  and  found  wanting. 

Our  practitioners,  or  many  of  them,  have  got  back  to 


64  BORDER  LINES   OF  KNOWLEDGE 

the  ways  of  old  Dr.  Samuel  Danforth,  who,  as  it  is  well 
known,  had  strong  objections  to  the  use  of  the  lancet. 
By  and  by  a  new  reputation  will  be  made  by  some  dis- 
contented practitioner,  who,  tired  of  seeing  patients  die 
with  their  skins  full  of  whiskey  and  their  brains  muddy 
with  opium,  returns  to  a  bold  antiphlogistic  treatment, 
and  has  the  luck  to  see  a  few  patients  of  note  get  well 
under  it.  So  of  the  remedies  which  have  gone  out  of 
fashion  and  been  superseded  by  others.  It  can  hardly 
be  doubted  that  they  will  come  into  vogue  again,  more 
or  less  extensively,  under  the  influence  of  that  irre- 
sistible demand  for  change  just  referred  to. 

Then  will  come  the  usual  talk  about  a  change  in 
the  character  of  disease,  which  has  about  as  much 
meaning  as  that  concerning  "  old-fashioned  snow- 
storms." "  Epidemic  constitutions  "  of  disease  mean 
something,  no  doubt ;  a  great  deal  as  applied  to  mala- 
rious affections ;  but  that  the  whole  type  of  diseases 
undergoes  such  changes  that  the  practice  must  be 
reversed  from  depleting  to  stimulating,  and  vice  versa, 
is  much  less  likely  than  that  methods  of  treatment  go 
out  of  fashion  and  come  in  again.  If  there  is  any 
disease  which  claims  its  percentage  with  reasonable 
uniformity,  it  is  phthisis.  Yet  I  remember  that  the 
reverend  and  venerable  Dr.  Prince,  of  Salem,  told  me 
one  Commencement  day,  as  I  was  jogging  along  to- 
wards Cambridge  with  him,  that  he  recollected  the 
time  when  that  disease  was  hardly  known;  and  in 
confirmation   of   his   statement    mentioned   a  case   in 


IN  MEDICAL  SCIENCE.  65 

which  it  was  told  as  a  great  event,  that  somebody 
down  on  "  the  Cape  "  had  died  of  "  a  consumption." 
This  story  does  not  sound  probable  to  myself,  as  I 
repeat  it,  yet  I  assure  you  it  is  true,  and  it  shows 
how  cautiously  we  must  receive  all  popular  stories 
of  great  changes  in  the  habits  of  disease.* 

Is  there  no  progress,  then,  but  do  we  return  to  the 
same  beliefs  and  practices  which  our  forefathers  wore 
out  and  threw  away  ?  I  trust  and  believe  that  there 
is  a  real  progress.  We  may,  for  instance,  return  in 
a  measure  to  the  Brunonian  stimulating  system,  but 
it  must  be  in  a  modified  way,  for  we  cannot  go  back 
to  the  simple  Brunonian  pathology,  since  we  have 
learned  too  much  of  diseased  action  to  accept  its  con- 
venient dualism.  So  of  other  doctrines,  each  new 
Avatar  strips  them  of  some  of  their  old  pretensions, 
until  they  take  their  fitting  place  at  last,  if  they 
have  any  truth  in  them,  or  disappear,  if  they  were 
mere  phantasms  of  the  imagination. 

In  the  mean  time,  while  medical  theories  are  com- 
ing in  and  going  out,  there  is  a  set  of  sensible  men 
who  are  never  run  away  with  by  them,  but  practise 
their  art  sagaciously  and  faithfully  in  much  the  same 
way  from  generation  to  generation.  From  the  time 
of  Hippocrates  to  that  of  our  own  medical  patriarch, 
there  has  been  an  apostolic  succession  of  wise  and  good 
practitioners.     If  you  will  look  at  the  first  aphorism 

*  See  Brit,  and  For.  Med.-Chir.  Rev.  for  Oct.,  1860,  p.  239.    The  last  two 
paragraphs  were  in  type  before  I  had  seen  the  article  here  referred  to. 


66  BORDER  LINES  OF  KNOWLEDGE 

of  the  ancient  Master,  you  will  see  that  before  all  rem- 
edies he  places  the  proper  conduct  of  the  patient  and 
his  attendants,  and  the  fit  ordering  of  all  the  condi- 
tions surrounding  him.  The  class  of  practitioners  I 
have  referred  to  have  always  been  the  most  faithful  in 
attending  to  these  points.  No  doubt  they  have  some- 
times prescribed  unwisely,  in  compliance  with  the 
prejudices  of  their  time,  but  they  have  grown  wiser 
as  they  have  grown  older,  and  learned  to  trust  more 
in  nature  and  less  in  their  plans  of  interference.  I 
believe  common  opinion  confirms  Sir  James  Clark's 
observation  to  this  effect. 

The  experience  of  the  profession  must,  I  think,  run 
parallel  with  that  of  the  wisest  of  its  individual  mem- 
bers. Each  time  a  plan  of  treatment  or  a  particular 
remedy  comes  up  for  trial,  it  is  submitted  to  a  sharper 
scrutiny.  When  Cullen  wrote  his  Materia  Medica,  he 
had  seriously  to  assail  the  practice  of  giving  burnt 
toad,  which  was  still  countenanced  by  at  least  one 
medical  authority  of  note.  I  have  read  recently  in 
some  medical  journal,  that  an  American  practitioner, 
whose  name  is  known  to  the  country,  is  prescribing 
the  hoof  of  a  horse  for  epilepsy.  It  was  doubtless  sug- 
gested by  that  old  fancy  of  wearing  a  portion  of  elk's- 
hoof  hung  round  the  neck  or  in  a  ring,  for  this  dis- 
ease. But  it  is  hard  to  persuade  reasonable  people  to 
swallow  the  abominations  of  a  former  period.  The 
evidence  which  satisfied  Fernelius  will  not  serve  one 
of  our  hospital  physicians. 


IN  MEDICAL   SCIENCE.  67 

In  this  way  those  articles  of  the  Materia  Medica 
which  had  nothing  but  loathsomeness  to  recommend 
them  have  been  gradually  dropped,  and  are  not  like 
to  obtain  any  general  favor  again  with  civilized  com- 
munities. The  next  culprits  to  be  tried  are  the  poi- 
sons. I  have  never  been  in  the  least  sceptical  as  to 
the  utility  of  some  of  them,  when  properly  employed. 
Though  I  believe  that  at  present,  taking  the  world  at 
large,  and  leaving  out  a  few  powerful  agents  of  such 
immense  value  that  they  rank  next  to  food  in  impor- 
tance, the  poisons  prescribed  for  disease  do  more  hurt 
than  good,  I  have  no  doubt,  and  never  professed  to  have 
any,  that  they  do  much  good  in  prudent  and  instructed 
hands.  But  I  am  very  willing  to  confess  a  great  jeal- 
ousy of  many  agents,  and  I  could  almost  wish  to  see 
the  Materia  Medica  so  classed  as  to  call  suspicion  upon 
certain  ones  among  them. 

Thus  the  alien  elements^  those  which  do  not  properly 
enter  into  the  composition  of  any  living  tissue,  are  the 
most  to  be  suspected, — mercury,  lead,  antimony,  silver, 
and  the  rest,  for  the  reasons  I  have  before  mentioned. 
Even  iodine,  which,  as  it  is  found  in  certain  plants, 
seems  less  remote  from  the  animal  tissues,  gives  une- 
quivocal proofs  from  time  to  time  that  it  is  hostile  to 
some  portions  of  the  glandular  system. 

There  is,  of  course,  less  prima  facie  objection  to 
those  agents  which  consist  of  assimilable  elements, 
such  as  are  found  making-  a  part  of  healthy  tissues. 
These  are  divisible  into  three  classes,  —  foods,  poisons, 


68  BORDER  LINES   OF   KNOWLEDGE 

and  inert,  mostly  because  insoluble,  substances.  The 
food  of  one  animal  or  of  one  human  being  is  some- 
times poison  to  another,  and  vice  versa;  inert  sub- 
stances may  act  mechanically,  so  as  to  produce  the 
effect  of  poisons ;  but  this  division  holds  exactly 
enough  for  our  purpose. 

Strictly  speaking,  every  poison  consisting  of  assimi- 
lable elements  may  be  considered  as  unwholesome  food. 
It  is  rejected  by  the  stomach,  or  it  produces  diarrhoea, 
or  it  causes  vertigo  or  disturbance  of  the  heart's  ac- 
tion, or  some  other  symptom  for  which  the  subject 
of  it  would  consult  the  physician,  if  it  came  on  from 
any  other  cause  than  taking  it  under  the  name  of 
medicine.  Yet  portions  of  this  unwholesome  food 
which  we  call  medicine,  we  have  reason  to  believe, 
are  assimilated ;  thus,  castor-oil  appears  to  be  par- 
tially digested  by  infants,  so  that  they  require  large 
doses  to  affect  them  medicinally.  Even  that  deadliest 
of  poisons,  hydrocyanic  acid,  is  probably  assimilated, 
and  helps  to  make  living  tissue,  if  it  do  not  kill  the 
patient,  for  the  assimilable  elements  which  it  contains, 
given  in  the  separate  forms  of  amygdalin  and  emulsin, 
produce  no  disturbance,  unless,  as  in  Bernard's  ex- 
periments, they  are  suffered  to  meet  in  the  digestive 
organs.  A  medicine  consisting  of  assimilable  sub- 
stances being  then  simply  unwholesome  food,  we  un- 
derstand what  is  meant  by  those  cumulative  effects  of 
such  remedies  often  observed,  as  in  the  case  of  digi- 
talis and  strychnia.     They  are  precisely  similar  to  the 


IN  MEDICAL   SCIENCE.  69 

cumulative  effects  of  a  salt  diet  in  producing  scurvy, 
or  of  spurred  rye  in  producing  dry  gangrene.  As 
the  effects  of  such  substances  are  a  violence  to  the 
organs,  we  should  exercise  the  same  caution  with  re- 
gard to  their  use  that  we  would  exercise  about  any 
other  kind  of  poisonous  food, — -partridges  at  certain 
seasons,  for  instance.  Even  where  these  poisonous 
kinds  of  food  seem  to  be  useful,  we  should  still  regard 
them  with  great  jealousy.  Digitalis  lowers  the  pulse 
in  febrile  conditions.  Veratrum  viride  does  the  same 
thing.  How  do  we  know  that  a  rapid  pulse  is  not  a 
normal  adjustment  of  nature  to  the  condition  it  accom- 
panies? Digitalis  has  gone  out  of  favor;  how  sure 
are  we  that  Veratrum  viride  will  not  be  found  to  do 
more  harm  than  good  in  a  case  of  internal  inflammation, 
taking  the  whole  course  of  the  disease  into  considera- 
tion? Think  of  the  change  of  opinion  with  regard 
to  the  use  of  opium  in  delirium  tremens,  (which  you 
remember  is  sometimes  called  delirium  vigilans^)  where 
it  seemed  so  obviously  indicated,  since  the  publica- 
tion of  Dr.  Ware's  admirable  essay.  I  respect  the 
evidence  of  my  contemporaries,  but  I  cannot  forget 
the  sayings  of  the  Father  of  medicine,  —  Ars  longa, 
judicium  difficile. 

I  am  not  presuming  to  express  an  opinion  concern- 
ing Veratrum  viride,  which  was  little  heard  of  when 
I  was  still  practising  medicine.  I  am  only  appealing 
to  that  higher  court  of  experience  which  sits  in  judg- 


70  BORDER  LINES   OF  KNOWLEDGE 

ment  on  all  decisions  of  the  lower  medical  tribunals, 
and  which  requires  more  than  one  generation  for  its 
final  verdict. 

Once  change  the  habit  of  mind  so  long  prevalent 
among  practitioners  of  medicine ;  once  let  it  be  every- 
where understood  that  the  presumption  is  in  favor  of 
food,  and  hot  of  alien  substances,  of  innocuous,  and  not 
of  unwholesome  food,  for  the  sick ;  that  this  presump- 
tion requires  very  strong  evidence  in  each  particular 
case  to  overcome  it ;  but  that,  when  such  evidence  is 
afforded,  the  alien  substance  or  the  unwholesome  food 
should  be  given  boldly,  in  sufficient  quantities,  in  the 
same  spirit  as  that  with  which  the  surgeon  lifts  his 
knife  against  a  patient,  —  that  is,  with  the  same  reluc- 
tance and  the  same  determination,  —  and  I  think  we 
shall  have  and  hear  much  less  of  charlatanism  in  and 
out  of  the  profession.  The  disgrace  of  medicine  has 
been  that  colossal  system  of  self-deception,  in  obedience 
to  which  mines  have  been  emptied  of  their  cankering 
minerals,  the  vegetable  kingdom  robbed  of  all  its 
noxious  growths,  the  entrails  of  animals  taxed  for  their 
impurities,  the  poison-bags  of  reptiles  drained  of  their 
venom,  and  all  the  inconceivable  abominations  thus 
obtained  thrust  down  the  throats  of  human  beings 
suffering  from  some  fault  of  organization,  nourishment, 
or  vital  stimulation. 

Much  as  we  have  gained,  we  have  not  yet  thor- 
oughly shaken  off  the  notion  that  poison  is  the  natural 


IN  MEDICAL   SCIENCE.  71 

food  of  disease,  as  wholesome  aliment  is  the  support 
of  health.  Cowper's  lines,  in  The  Task,  show  the 
matter-of-course  practice  of  his  time  :  — 

"  He  does  not  scorn  it,  who  has  long  endured 
A  fever's  agonies,  and/ecZ  on  drugs." 

Dr.  Kimball,  of  Lowell,  who  has  been  in  the  habit  of 
seeing  a  great  deal  more  of  typhoid  fever  than  most 
practitioners,  and  whose  surgical  exploits  show  him 
not  to  be  wanting  in  boldness  or  enterprise,  can  tell 
you  whether  he  finds  it  necessary  to  feed  his  patients 
on  drugs  or  not.  His  experience  is,  I  believe,  that 
of  the  most  enlightened  and  advanced  portion  of  the 
profession;  yet  I  think  that  even  in  typhoid  fever, 
and  certainly  in  many  other  complaints,  the  effects  of 
ancient  habits  and  prejudices  may  still  be  seen  in  the 
practice  of  some  educated  physicians. 

To  you,  young  men,  it  belongs  to  judge  all  that 
has  gone  before  you.  You  come  nearer  to  the  great 
fathers  of  modern  medicine  than  some  of  you  imagine. 
Three  of  my  own  instructors  attended  Dr.  Rush's 
Lectures.  The  illustrious  Haller  mentions  Rush's  in- 
augural thesis  *  in  his  Bibliotheca  Anatomica ;  and 
this  same  Haller,  brought  so  close  to  us,  tells  us  he 
remembers  Ruysch,  then  an  old  man,  and  used  to 
carry  letters  between  him  and  Boerhaave.f  Look 
through   the  history  of  medicine  from  Boerhaave  to 

*  De  Coctione  Ciborum  in  Venlriculo.    Edinb.  1768.  —  Bibl.  Anat.  II.  657. 
f  "  Saepissime  bonum  senem  vidi,  ssepe  Boerha avium  inter  et  ipsum 
literarum  vector."    Ibid.,  I.  529. 


72  BOEDER  LINES   OF  KNOWLEDGE 

this  present  day.  You  will  see  at  once  that  medical 
doctrine  and  practice  have  undergone  a  long  series  of 
changes.  You  will  see  that  the  doctrine  and  practice 
of  our  own  time  must  probably  change  in  their  turn, 
and  that,  if  we  can  trust  at  all  to  the  indications  of 
their  course,  it  will  be  in  the  direction  of  an  improved 
hygiene  and  a  simplified  treatment.  Especially  will  the 
old  habit  of  violating  the  instincts  of  the  sick  give  place 
to  a  judicious  study  of  these  same  instincts.  It  will  be 
found  that  bodily,  like  mental  insanity,  is  best  man- 
aged, for  the  most  part,  by  natural  soothing  agencies. 
Two  centuries  ago  there  was  a  prescription  for  scurvy 
containing  "  stercoris  taurini  et  anserini  par  quantitas 
trium  magnarum  nucum"  of  the  hell-broth  containing 
which  "quoties-eumque  sitit  ceger,  large  bibit."  *  When 
I  have  recalled  the  humane  common-sense  of  Captain 
Cook  in  the  matter  of  preventing  this  disease ;  when 
I  have  heard  my  friend,  Mr.  Dana,  describing  the 
avidity  with  which  the  scurvy-stricken  sailors  snuffed 
up  the  earthy  fragrance  of  fresh  raw  potatoes,  the  food 
which  was  to  supply  the  elements  wanting  to  their 
spongy  tissues,  —  I  have  recognized  that  the  perfection 
of  art  is  often  a  return  to  nature,  and  seen  in  this 
single  instance  the  germ  of  innumerable  beneficent 
future  medical  reforms. 

I  cannot  help  believing  that  medical  curative  treat- 
ment will  by  and  by  resolve  itself  in  great  measure 
into  modifications  of  the  food,  swallowed  and  breathed, 

*  Schenck,  Observ.  Med.  Rev.,  (Lugdnni,  1643,)  p.  800. 


IN  MEDICAL   SCIENCE.  73 

and  of  the  natural  stimuli,  and  that  less  will  be  ex- 
pected from  specifics  and  noxious  disturbing  agents, 
either  alien  or  assimilable.  The  noted  mineral-waters 
containing  iron,  sulphur,  carbonic  acid,  supply  nutri- 
tious or  stimulating  materials  to  the  body  as  much  as 
phosphate  of  lime  and  ammoniacal  compounds  do  to 
the  cereal  plants.  The  effects  of  a  milk  and  vegetable 
diet,  of  gluten  bread  in  diabetes,  of  cod-liver  oil  in 
phthisis,  even  of  such  audacious  innovations  as  the 
water-cure  and  the  grape-cure,  are  only  hints  of  what 
will  be  accomplished  when  we  have  learned  to  discover 
what  organic  elements  are  deficient  or  in  excess  in  a 
case  of  chronic  disease,  and  the  best  way  of  correcting 
the  abnormal  condition,  just  as  an  agriculturist  ascer- 
tains the  wants  of  his  crops  and  modifies  the  composi- 
tion of  his  soil.  In  acute  febrile  diseases  we  have  long 
ago  discovered  that  far  above  all  drug-medication  is 
the  use  of  mild  liquid  diet  in  the  period  of  excite- 
ment, and  of  stimulant  and  nutritious  food  in  that 
of  exhaustion.  Hippocrates  himself  was  as  particular 
about  his  barley-ptisan  as  any  Florence  Nightingale 
of  our  time  could  be. 

The  generation  to  which  you,  who  are  just  enter- 
ing the  profession,  belong,  will  make  a  vast  stride  for- 
ward, as  I  believe,  in  the  direction  of  treatment  by 
natural  rather  than  violent  agencies.  What  is  it  that 
makes  the  reputation  of  Sydenham,  as  the  chief  of 
English  physicians  ?  His  prescriptions  consisted  prin- 
cipally of  simples.  An  aperient  or  an  opiate,  a  "  car- 
4 


74  BORDER  LINES   OF  KNOWLEDGE 

diac  "  or  a  tonic,  may  be  commonly  found  in  the  midst 
of  a  somewhat  fantastic  miscellany  of  garden  herbs. 
It  was  not  by  his  pharmaceutic  prescriptions  that  he 
gained  his  great  name.  It  was  by  daring  to  order 
fresh  air  for  small-pox  patients,  and  riding  on  horse- 
bach  for  consumptives,  in  place  of  the  smothering  sys- 
tem, and  the  noxious  and  often  loathsome  rubbish  of 
the  established  schools.  Of  course  Sydenham  was 
much  abused  by  his  contemporaries,  as  he  frequently 
takes  occasion  to  remind  his  reader.  "  I  must  needs 
conclude,"  he  says,  "  either  that  I  am  void  of  merit, 
or  that  the  candid  and  ingenuous  part  of  mankind,  who 
are  formed  with  so  excellent  a  temper  of  mind  as  to 
be  no  strangers  to  gratitude,  make  a  very  small  part 
of  the  whole."  *  If  in  the  fearless  pursuit  of  truth 
you  should  find  the  world  as  ungracious  in  the  nine- 
teenth century  as  he  found  it  in  the  seventeenth,  you 
may  learn  a  lesson  of  self-reliance  from  another  utter- 
ance of  the  same  illustrious  physician:  "'Tis  none 
of  my  business  to  inquire  what  other  persons  think,  but 
to  establish  my  own  observations ;  in  order  to  which,  I 
ask  no  favor  of  the  reader  but  to  peruse  my  writings 
with  temper."  f 

The  physician  has 'learned  a  great  deal  from  the 
surgeon,  who  is  naturally  in  advance  of  him,  because 
he  has  a  better   opportunity  of  seeing   the   effects  of 

*  Of  the  Small-Pox  and  Hysteric  Diseases.     Epistle  to  Dr.  William 
Cole,  §  140,  Swan's  Translation, 
t  Works,  Preface,  p.  xxi. 


IN  MEDICAL   SCIENCE.  75 

his  remedies.  Let  me  shorten  one  of  Ambroise  Parens 
stories  for  you.  There  had  been  a  great  victory  at  the 
pass  of  Susa,  and  they  were  riding  into  the  city.  The 
wounded  cried  out  as  the  horses  trampled  them  under 
their  hoofs,  which  caused  good  Ambroise  great  pity, 
and  made  him  wish  himself  back  in  Paris.  Going  into 
a  stable  he  saw  four  dead  soldiers,  and  three  desper- 
ately wounded,  placed  with  their  backs  against  the 
wall.  An  old  campaigner  came  up.  —  "  Can  these  fel- 
lows get  well  ?  "  he  said.  "  No  !  "  answered  the  sur- 
geon. Thereupon,  the  old  soldier  walked  up  to  them 
and  cut  all  their  throats,  sweetly,  and  without  wrath 
(doulcement  et  sans  cholere).  Ambroise  told  him  he 
was  a  bad  man  to  do  such  a  thing.  "  I  hope  to  God," 
he  said,  "  somebody  will  do  as  much  for  me  if  I  ever 
get  into  such  a  scrape "  (accoustre  de  telle  fagoti). 
"  I  was  not  much  salted  in  those  days  "  (lien  doux  de 
seZ),  says  Ambroise,  "  and  little  acquainted  with  the 
treatment  of  wounds."  However,  as  he  tells  us,  he 
proceeded  to  apply  boiling  oil  of  Sambuc  (elder)  after 
the  approved  fashion  of  the  time,  —  with  what  torture 
to  the  patient  may  be  guessed.  At  last  his  precious 
oil  gave  out,,  and  he  used  instead  an  insignificant 
mixture  of  his  own  contrivance.  He  could  not  sleep 
that  night  for  fear  his  patients  who  had  not  been 
scalded  with  the  boiling  oil  would  be  poisoned  by 
the  gunpowder  conveyed  into  their  wounds  by  the 
balls.  To  his  surprise,  he  found  them  much  better 
than  the  others  the  next  morning,  and  resolved  never 


76  BORDER   LINES   OF   KNOWLEDGE 

again  to  burn  his  patients  with  hot  oil  for  gun-shot 
wounds.* 

This  was  the  beginning,  as  nearly  as  we  can  fix  it, 
of  that  reform  which  has  introduced  plain  water-dress- 
ings in  the  place  of  the  farrago  of  external  applications 
which  had  been  a  source  of  profit  to  apothecaries  and 
disgrace  to  art  from,  and  before,  the  time  when  Pliny 
complained  of  them.  A  young  surgeon  who  was  at 
Sudley  Church,  laboring  among  the  wounded  of  Bull- 
Run,  tells  me  they  had  nothing  but  water  for  dressing, 
and  he  (being  also  doux  de  sel)  was  astonished  to  see 
how  well  the  wounds  did  under  that  simple  treat- 
ment. 

Let  me  here  mention  a  fact  or  two  which  may  be  of 
use  to  some  of  you  who  mean  to  enter  the  public  ser- 
vice. You  will,  as  it  seems,  have  gun-shot  wounds 
almost  exclusively  to  deal  with.  Three  different  sur- 
geons, the  one  just  mentioned  and  two  who  saw  the 
wounded  of  Big  Bethel,  assured  me  that  they  found 
no  sabre-cuts  or  bayonet-wounds.  It  is  the  rifle-bullet 
from  a  safe  distance  which  pierces  the  breasts  of  our 
soldiers,  and  not  the  gallant  charge  of  broad  platoons 
and  sweeping  squadrons,  such  as  we  have  been  in  the 
habit  of  considering  the  chosen  mode  of  warfare  of 
ancient  and  modern  chivalry.f 

*  Le  Voyage  de  Thurin,  (Euvres,  (Paris,  1579,)  p.  1198. 

t  Sir  Charles  James  Napier  had  the  same  experience  in  Virginia  in 
1813.  "  Potomac.  We  have  nasty  sort  of  fighting  here,  amongst  creeks 
and  bushes,  and  lose  men  without  show."  "  Yankee  never  shows  himself, 
he  keeps  in  the  thickest  wood,  fires  and  runs  off"."    "  These  five  thousand 


IN  MEDICAL   SCIENCE.  77 

Another  fact  parallels  the  story  of  the  old  cam- 
paigner, and  may  teach  some  of  you  caution  in  se- 
lecting your  assistants.  A  chaplain  told  it  to  two  of 
our  officers  personally  known  to  myself.  He  over- 
heard the  examination  of  a  man  who  wished  to  drive 
one  of  the  "  avalanche "  wagons,  as  they  call  them. 
The  man  was  asked  if  he  knew  how  to  deal  with 
wounded  men.  "  O  yes,"  he  answered  ;  "  if  they  're 
hit  here"  pointing  to  the  abdomen,  " knock  'em  on  the 
head,  —  they  can't  get  well." 

In  art  and  outside  of  it  you  will  meet  the  same  bar- 
barisms that  Ambroise  Pare*  met  with,  —  for  men  differ 
less  from  century  to  century  than  we  are  apt  to  sup- 
pose ;  you  will  encounter  the  same  opposition,  if  you 
attack  any  prevailing  opinion,  that  Sydenham  com- 
plained of.  So  far  as  possible,  let  not  such  experien- 
ces breed  in  you  a  contempt  for  those  who  are  the 
subjects  of  folly  or  prejudice,  or  foster  any  love  of  dis- 
pute for  its  own  sake.  Should  you  become  authors, 
express  your  opinions  freely ;  defend  them  rarely.  It 
is  not  often  that  an  opinion  is  worth  expressing,  which 
cannot  take  care  of  itself.  Opposition  is  the  best 
mordant  to  fix  the  color  of  your  thought  in  the  gen- 
eral belief. 

in  the  open  field  might  be  attacked,  but  behind  works  it  would  be  throw- 
ing away  lives."  He  calls  it  "  an  inglorious  warfare,"  —  says  one  of  the 
leaders  is  "  a  little  deficient  in  gumption,"  — but  "  still  my  opinion  is,  that 
if  we  tuck  up  our  sleeves  and  lay  our  ears  back  we  might  thrash  them  ; 
that  is,  if  we  caught  them  out  of  their  trees,  so  as  to  slap  at  them  with 
the  bayonet."  —  Life,  etc.,  Vol.  I.  p.  218,  et  $eq. 


78  BORDER   LINES   OF  KNOWLEDGE 

It  is  time  to  bring  these  crowded  remarks  to  a  close. 
The  day  has  been  when  at  the  beginning  of  a  course  of 
Lectures  I  should  have  thought  it  fitting  to  exhort 
you  to  diligence  and  entire  devotion  to  your  tasks  as 
students.  It  is  not  so  now.  The  young  man  who  has 
not  heard  the  clarion-voices  of  honor  and  of  duty  now- 
sounding  throughout  the  land,  will  heed  no  word  of 
mine.  In  the  camp  or  the  city,  in  the  field  or  the 
hospital,  under  sheltering  roof,  or  half-protecting  can- 
vas, or  open  sky,  shedding  our  own  blood  or  stanching 
that  of  our  wounded  defenders,  students  or  teachers,  — 
whatever  our  calling  and  our  ability,  we  belong,  not  to 
ourselves,  but  to  our  imperilled  country,  whose  danger 
is  our  calamity,  whose  ruin  would  be  our  enslavement, 
whose  rescue  shall  be  our  earthly  salvation  ! 

You  cannot  all  follow  the  armies  of  your  country  to 
the  field.  But  remember  that  he  who  labors  for  the 
general  good  at  home  is  an  ununiformed  soldier  in  the 
same  holy  cause  with  those  who  bear  arms  or  minister 
at  the  side  of  the  ambulance  and  in  the  camp  hospital. 
Larrey  claimed  no  precedence  of  Dupuytren,  nor 
Guthrie  of  Sir  Astley  Cooper.  As  for  the  nobleness  of 
the  task  for  which  you  are  preparing  yourselves,  I  do 
not  know  that  I  can  speak  of  it  more  strongly  in  prose 
than  I  did  in  the  peaceful  times  before  these  days  of 
trial,  in  the  form  of  verse,  and  I  will  so  far  trespass 
on  your  time  and  patience  as  to  close  this  Lecture  by 
reading  you 


IN  MEDICAL   SCIENCE.  79 


THE    TWO    AEMIES. 

As  Life's  unending  column  pours, 
Two  marshalled  hosts  are  seen,  — 

Two  armies  on  the  trampled  shores 
That  Death  flows  black  between. 

One  marches  to  the  drum-beat's  roll, 
The  wide-mouthed  clarion's  bray, 

And  bears  upon  a  crimson  scroll, 
"  Our  glory  is  to  slay." 

One  moves  in  silence  by  tne  stream, 

With  sad,  yet  watchful  eyes, 
Calm  as  the  patient  planet's  gleam 

That  walks  the  clouded  skies. 

Along  its  front  no  sabres  shine, 
No  blood-red  pennons  wave  ; 

Its  banner  bears  the  single  line, 
"  Our  duty  is  to  save." 

For  those  no  death-bed's  lingering  shade ; 

At  Honor's  trumpet-call, 
With  knitted  brow  and  lifted  blade 

In  Glory's  arms  they  fall. 

For  these  no  clashing  falchions  bright, 

No  stirring  battle-cry ; 
The  bloodless  stabber  calls  by  night,  — 

Each  answers,  "  Here  ami!" 


80      BORDER  LINES  OF  KNOWLEDGE  IN  MEDICAL  SCIENCE. 

For  those  the  sculptor's  laurelled  bust, 

The  builder's  marble  piles, 
The  anthems  pealing  o'er  their  dust 

Through  long  cathedral  aisles. 

For  these  the  blossom-sprinkled  turf 

That  floods  the  lonely  graves, 
When  Spring  rolls  in  her  sea-green  surf 

In  flowery-foaming  waves. 

Two  paths  lead  upward  from  below, 

And  angels  wait  above, 
Who  count  each  burning  life-drop's  flow, 

Each  falling  tear  of  Love. 

Though  from  the  Hero's  bleeding  breast 

Her  pulses  Freedom  drew, 
Though  the  white  lilies  in  her  crest 

Sprang  from  that  scarlet  dew,  — 

While  "Valor's  haughty  champions  wait 

Till  all  their  scars  are  shown, 
Love  walks  unchallenged  through  the  gate, 

To  sit  beside  the  Throne ! 


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